Metabolic Parameters as Predictors for Progression Free and Overall Survival of Patients with Metastatic Colorectal Canc
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ORIGINAL ARTICLE
Metabolic Parameters as Predictors for Progression Free and Overall Survival of Patients with Metastatic Colorectal Cancer Zsuzsanna Nemeth 1,2 & Wouter Wijker 3 & Zsolt Lengyel 4 & Erika Hitre 1 & Katalin Borbely 5 Received: 5 June 2020 / Accepted: 23 June 2020 # The Author(s) 2020
Abstract We tested the prognostic relevance of metabolic parameters and their relative changes in patients with metastatic colorectal cancer (mCRC) treated with monoclonal antibody and chemotherapy. SUVmax (standardized uptake volume), SAM (standardized added metabolic activity) and TLG (total lesion glycolysis) are assessed with 1 8 Ffluorodeoxyglucosepositron emission tomography and computed tomography (FDG-PET/CT) to evaluate total metabolic activity of malignant processes. Our purpose was to investigate the change of glucose metabolism in relation to PFS (progression free survival) and OS (overall survival). Fifty-three patients with mCRC with at least one measurable liver metastasis were included in this prospective, multi-center, early exploratory study. All patients were treated with firstline chemotherapy and targeted therapy. Metabolic parameters, like SUVmax, SAM, normalized SAM (NSAM) and TLG were assessed by FDG-PET/CT, carried out at baseline (scan-1) and after two therapeutic cycle (scan-2). Our results suggested neither SUVmax nor TLG have such prognostic value as NSAM in liver metastases of colorectal cancer. The parameters after the two cycles of chemotherapy proved to be better predictors of the clinical outcome. NSAM after two cycles of treatment has a statistically significant predictive value on OS, while SAM was predictive to the PFS. The follow up normalized SAM after 2 cycles of first line oncotherapy was demonstrated to be useful as prognostic biomarkers for OS in metastatic colorectal cancer. We should introduce this measurement in metastatic colorectal cancer if there is at least one metastasis in the liver. Keywords Standardized added metabolic activity . FDG-PET/CT . Interim . Metastatic colorectal cancer . Overall survival . Progression free survival . Response
Abbreviations AUC BG
FDG-PET/CT Area Under the Curve Background
18
F-Fluorodeoxyglucose Positron Emission Tomography and Computed Tomography
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12253-020-00865-5) contains supplementary material, which is available to authorized users. * Zsuzsanna Nemeth [email protected] Wouter Wijker [email protected] Zsolt Lengyel [email protected] Erika Hitre [email protected] Katalin Borbely [email protected]
1
Chemotherapy B and Clinical Pharmacological Department of National Institute of Oncology, Ráth György utca 7-9, Budapest 1122, Hungary
2
Oncology Department of Szent Margit Hospital, Bécsi út 132, Budapest H-1032, Hungary
3
Auxiliis Pharma Ltd, Bokor utca 17, Budapest H-1037, Hungary
4
Pozitron Diagnostic Ltd, Hunyadi ut 9-11, Budapest 1117, Hungary
5
PET Ambulatory Department of National Institute of Onc
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