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Evaluating radiological response in pancreatic neuroendocrine tumours treated with sunitinib: comparison of Choi versus RECIST criteria (CRIPNET_ GETNE1504 study)

AuthorsSolis-Hernandez, Mª Pilar; Fernández del Valle, Ana; Carmona-Bayonas, A.; García-Carbonero, Rocío CSIC ORCID; Custodio, Ana; Benavent, Marta; Alonso Gordoa, Teresa; Nuñéz-Valdovino, Bárbara; Sánchez Canovas, Manuel; Matos, Ignacio; Alonso, Vicente; López, Carlos; Viudez, Antonio; Izquierdo, Marta CSIC ORCID; Calvo-Temprano, David; Grande, Enrique; Capdevila, Jaume; Jiménez-Fonseca, Paula
Issue Date2019
PublisherSpringer Nature
CitationBritish Journal of Cancer 121: 537-544 (2019)
Abstract[Background] The purpose of our study was to analyse the usefulness of Choi criteria versus RECIST in patients with pancreatic neuroendocrine tumours (PanNETs) treated with sunitinib. [Method] A multicentre, prospective study was conducted in 10 Spanish centres. Computed tomographies, at least every 6 months, were centrally evaluated until tumour progression. [Results] One hundred and seven patients were included. Median progression-free survival (PFS) by RECIST and Choi were 11.42 (95% confidence interval [CI], 9.7–15.9) and 15.8 months (95% CI, 13.9–25.7). PFS by Choi (Kendall’s τ = 0.72) exhibited greater correlation with overall survival (OS) than PFS by RECIST (Kendall’s τ = 0.43). RECIST incorrectly estimated prognosis in 49.6%. Partial response rate increased from 12.8% to 47.4% with Choi criteria. Twenty-four percent of patients with progressive disease according to Choi had stable disease as per RECIST, overestimating treatment effect. Choi criteria predicted PFS/OS. Changes in attenuation occurred early and accounted for 21% of the variations in tumour volume. Attenuation and tumour growth rate (TGR) were associated with improved survival. [Conclusion] Choi criteria were able to capture sunitinib’s activity in a clinically significant manner better than RECIST; their implementation in standard clinical practice shall be strongly considered in PanNET patients treated with this drug.
Publisher version (URL)https://doi.org/10.1038/s41416-019-0558-7
Identifiersdoi: 10.1038/s41416-019-0558-7
issn: 0007-0920
e-issn: 1532-1827
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