Abstract 5773
Background
Anal Squamous Cell Carcinoma (ASCC) is radically treated by chemoradiotherapy (CRT). The use of DW-MRI as a predictive marker of outcome would enable early individualisation of treatment. We aimed to quantify the changes in mean apparent-diffusion-coefficient (ADCMean) between a DW-MRI at diagnosis and on fraction 8-10 of CRT as a biomarker for cellularity, and correlate these with outcome.
Methods
This prospective study recruited patients with ASCC between October 2014 and November 2017. DW-MRI was performed at diagnosis and after fraction 8-10 of radical CRT. A region of interest (ROI) was delineated for all primary tumours and any lymph nodes >2 cm on high-resolution T2 –weighted images and propagated to the ADC map. A pre-defined cut-off for percentage change in ADCMean (ΔADC) was set at < 20%. Complete response (CR) was assessed 3 months following completion of CRT. Routine clinical follow up data from patients were collected from NHS electronic systems.
Results
Twenty-three of 29 recruited patients underwent paired DW-MRI scans. The median (range) tumour volume was 13.6 cm3 (2.8 cm3 to 84.9 cm3). The median ΔADCMean between scans was 20.7% (95% CI: 12.7%, 34.1%). Nine of 23 (43%) patients had a change of ADCMean <20%. Two patients failed to achieve a CR, with ΔADCMean of 14.6% and 20.3%, respectively. On routine follow up, 2 further patients had relapsed, with ΔADCMean of -1.2% and 6.8%.
Conclusions
In a subset of patients, <20% ΔADCMean on DW-MRI between diagnosis and day 8-10 of CRT was observed. Four patients in the study demonstrated persistent or recurrent disease, all of whom demonstrated an ADC on or below the pre-specified cut-off. Further investigation of the predictive merit of DW-MRI change, and the optimum cut-off is needed in larger cohorts.
Clinical trial identification
NCT02145416.
Editorial acknowledgement
Legal entity responsible for the study
University of Oxford.
Funding
CRUK EPSRC Cancer Imaging Centre in Oxford, the CRUK Oxford Centre and the NIHR.M Hawkins is supported by Medical Research Council grant MC_UU_00001/2.
Disclosure
R. Muirhead: Honoraria (self), Fee for lecture: Boehringer Ingelheim. V. Goh: Research grant / Funding (self): Siemens. All other authors have declared no conflicts of interest.
Resources from the same session
2674 - Multicenter Phase I Trial of Trastuzumab Emtansine (T-DM1) in Combination with Non-Pegylated Liposomal Doxorubicin (NPLD) in HER2[+] Metastatic Breast Cancer (MBC). THELMA Study
Presenter: Elena López-Miranda
Session: Poster Display session 2
Resources:
Abstract
1398 - Phase 1 study of liposomal formulation of eribulin (E7389-LF) in patients (pts) with advanced solid tumors: primary results of dose-escalation part
Presenter: Noboru Yamamoto
Session: Poster Display session 2
Resources:
Abstract
5818 - Polo-like Kinase 1 inhibitor onvansertib synergizes with paclitaxel in breast cancer carrying p53 mutation
Presenter: Antonio Giordano
Session: Poster Display session 2
Resources:
Abstract
5927 - Phase 1b study of heat shock protein 90 inhibitor, onalespib in combination with paclitaxel in patients with advanced, triple negative breast cancer (NCT02474173).
Presenter: Robert Wesolowski
Session: Poster Display session 2
Resources:
Abstract
1695 - Impact of pertuzumab and T-DM1 on prognosis of HER2-positive metastatic breast cancer (MBC) and factors affecting their efficacy: results from the AGMT_MBC-Registry
Presenter: Simon Peter Gampenrieder
Session: Poster Display session 2
Resources:
Abstract
1742 - Clinical profile and outcome of HER2 positive breast cancer patients with brain metastases treated with HER2 targeted therapy: Real world experience.
Presenter: Prabhat Bhargava
Session: Poster Display session 2
Resources:
Abstract
1846 - Pertuzumab, trastuzumab, and docetaxel for HER2-positive metastatic breast cancer: results of single arm phase IV COMACHI study
Presenter: Norikazu Masuda
Session: Poster Display session 2
Resources:
Abstract
5385 - Anti HER-2 Therapies and Left Ventricular Dysfunction The Renaissance Study
Presenter: ANDRES DANIELE
Session: Poster Display session 2
Resources:
Abstract
3320 - Safety and efficacy of T-DM1 in 128 patients with advanced HER2+ breast cancer: The Royal Marsden experience.
Presenter: Nicolò Battisti
Session: Poster Display session 2
Resources:
Abstract
4540 - Use of trastuzumab emtansine (T-DM1; K) after pertuzumab + trastuzumab (PH) in patients with HER2-positive metastatic breast cancer (mBC): challenges in assessing effectiveness of treatment sequencing in the real world (RW)
Presenter: Thibaut Sanglier
Session: Poster Display session 2
Resources:
Abstract