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CT imaging taken post avastin may predict survival in patients with metastatic colorectal cancer
Date:12/1/2009

HOUSTON - Using routine computed tomography (CT) imaging to analyze form and structural changes to colorectal liver metastasis after bevacizumab and chemotherapy may predict overall survival, according to research from The University of Texas M. D. Anderson Cancer Center.

The findings are published in the Dec. 2 issue of JAMA.

When combined with chemotherapy, the angiogenesis inhibitor bevacizumab, also known as Avastin, is associated with both improved survival in those with metastatic colorectal cancer and higher rates of pathologic response in patients undergoing surgical resection of colorectal liver metastases. The monoclonal antibody was approved for use in the front line setting of metastatic colorectal cancer in 2004.

However, the therapy presents a unique set of challenges, explains Jean-Nicolas Vauthey, M.D., professor in M. D. Anderson's Department of Surgical Oncology.

"We've known for years that tumor shrinkage is not necessarily a strong indicator of survival in this patient population, and this has been an area of much controversy and study within the cancer community," explained Vauthey, the study's corresponding author. "Some of these tumors are so aggressive and may immediately start to grow when a patient goes off bevacizumab-containing chemotherapy."

Prior to the JAMA study, Vauthey and his M. D. Anderson colleagues looked at pathology in patients who had undergone resection for colorectal liver metastasis, and found those who received bevacizumab in combination with chemotherapy achieved better pathologic response rates. Based on that pathologic finding of increased cell kill, Vauthey and colleagues then conducted a second preliminary study and uncovered that these patients were distributed in three groups - complete, major and minor response - with a strong survival correlation.

"Pathologic response has proven to predict improved survival and has been proposed as a new e
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Contact: Laura Sussman
lsussman@mdanderson.org
713-745-2457
University of Texas M. D. Anderson Cancer Center
Source:Eurekalert

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