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Article Dans Une Revue Gut Année : 2020

Early evaluation using a radiomic signature of unresectable hepatic metastases to predict outcome in patients with colorectal cancer treated with FOLFIRI and bevacizumab

1 Service de Radiologie [CHU Cochin]
2 MUHC - McGill University Health Center [Montreal]
3 l'Institut de Recherche contre les Cancers de l'Appareil Digestif (IRCAD)
4 CHU Strasbourg - Centre Hospitalier Universitaire [Strasbourg]
5 Département radiologie diagnostique et interventionnelle Saint Eloi [CHRU Montpellier]
6 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
7 Fédération Francophone de la Cancérologie Digestive, FFCD
8 LNC - Lipides - Nutrition - Cancer [Dijon - U1231]
9 CHU Nantes - Centre Hospitalier Universitaire de Nantes
10 UNICANCER/CRLCC-CGFL - Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon]
11 Equipe EPICAD (LNC - U1231)
12 IGR - Institut Gustave Roussy
13 Oncologie digestive
14 UFR Médecine UPCité - UFR Médecine [Santé] - Université Paris Cité
15 HEGP - Hôpital Européen Georges Pompidou [APHP]
16 Hôpital universitaire Robert Debré [Reims]
17 UNICANCER/CAL - Centre de Lutte contre le Cancer Antoine Lacassagne [Nice]
18 CHU ST-E - Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne]
19 CRLCC Paul Strauss - Centre Paul Strauss
20 Service de chirurgie digestive (CH de La Roche-sur-Yon)
21 Service d'oncologie digestive et hépato-gastro-entérologie [Hôpital de la Timone - APHM]
22 CCGM - Centre de Cancérologie du Grand Montpellier
23 Centre Hospitalier Saint Jean de Perpignan
24 Polyclinique de Limoges - site François Chénieux [Limoges]
25 CHU Dijon - Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand
26 Hôpital Européen [Fondation Ambroise Paré - Marseille]
27 Centre Léon Bérard [Lyon]
28 CHU Mont de Marsan
29 CSJL - Clinique Saint-Jean Languedoc [Toulouse]
30 Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris]
31 CRESTIC - Centre de Recherche en Sciences et Technologies de l'Information et de la Communication - EA 3804
32 Hôpital Maison Blanche
33 URCA - Université de Reims Champagne-Ardenne
Jaafar Bennouna
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Résumé

Purpose: The objective of this study was to build and validate a radiomic signature to predict early a poor outcome using baseline and 2-month evaluation CT and to compare it to the RECIST1·1 and morphological criteria defined by changes in homogeneity and borders.Methods: This study is an ancillary study from the PRODIGE-9 multicentre prospective study for which 491 patients with metastatic colorectal cancer (mCRC) treated by 5-fluorouracil, leucovorin and irinotecan (FOLFIRI) and bevacizumab had been analysed. In 230 patients, computed texture analysis was performed on the dominant liver lesion (DLL) at baseline and 2 months after chemotherapy. RECIST1·1 evaluation was performed at 6 months. A radiomic signature (Survival PrEdiction in patients treated by FOLFIRI and bevacizumab for mCRC using contrast-enhanced CT TextuRe Analysis (SPECTRA) Score) combining the significant predictive features was built using multivariable Cox analysis in 120 patients, then locked, and validated in 110 patients. Overall survival (OS) was estimated with the Kaplan-Meier method and compared between groups with the logrank test. An external validation was performed in another cohort of 40 patients from the PRODIGE 20 Trial.Results: In the training cohort, the significant predictive features for OS were: decrease in sum of the target liver lesions (STL), (adjusted hasard-ratio(aHR)=13·7, p=1·93×10-7), decrease in kurtosis (ssf=4) (aHR=1·08, p=0·001) and high baseline density of DLL, (aHR=0·98, p<0·001). Patients with a SPECTRA Score >0·02 had a lower OS in the training cohort (p<0·0001), in the validation cohort (p<0·0008) and in the external validation cohort (p=0·0027). SPECTRA Score at 2 months had the same prognostic value as RECIST at 6 months, while non-response according to RECIST1·1 at 2 months was not associated with a lower OS in the validation cohort (p=0·238). Morphological response was not associated with OS (p=0·41).Conclusion: A radiomic signature (combining decrease in STL, density and computed texture analysis of the DLL) at baseline and 2-month CT was able to predict OS, and identify good responders better than RECIST1.1 criteria in patients with mCRC treated by FOLFIRI and bevacizumab as a first-line treatment. This tool should now be validated by further prospective studies.
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Dates et versions

hal-02483779 , version 1 (18-02-2020)

Identifiants

Citer

Anthony Dohan, Benoit Gallix, Boris Guiu, Karine Le Malicot, Caroline Reinhold, et al.. Early evaluation using a radiomic signature of unresectable hepatic metastases to predict outcome in patients with colorectal cancer treated with FOLFIRI and bevacizumab. Gut, 2020, 69 (3), pp.531-539. ⟨10.1136/gutjnl-2018-316407⟩. ⟨hal-02483779⟩
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