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Diffusion-Weighted MRI for Predicting Pathologic Complete Response in Neoadjuvant Immunotherapy.
Li, Wen; Le, Nu N; Onishi, Natsuko; Newitt, David C; Wilmes, Lisa J; Gibbs, Jessica E; Carmona-Bozo, Julia; Liang, Jiachao; Partridge, Savannah C; Price, Elissa R; Joe, Bonnie N; Kornak, John; Magbanua, Mark Jesus M; Nanda, Rita; LeStage, Barbara; Esserman, Laura J; Van't Veer, Laura J; Hylton, Nola M.
Afiliação
  • Li W; Department of Radiology and Biomedical Imaging, University of California, 550 16th Street, San Francisco, CA 94158, USA.
  • Le NN; Department of Radiology and Biomedical Imaging, University of California, 550 16th Street, San Francisco, CA 94158, USA.
  • Onishi N; Department of Radiology and Biomedical Imaging, University of California, 550 16th Street, San Francisco, CA 94158, USA.
  • Newitt DC; Department of Radiology and Biomedical Imaging, University of California, 550 16th Street, San Francisco, CA 94158, USA.
  • Wilmes LJ; Department of Radiology and Biomedical Imaging, University of California, 550 16th Street, San Francisco, CA 94158, USA.
  • Gibbs JE; Department of Radiology and Biomedical Imaging, University of California, 550 16th Street, San Francisco, CA 94158, USA.
  • Carmona-Bozo J; Department of Radiology and Biomedical Imaging, University of California, 550 16th Street, San Francisco, CA 94158, USA.
  • Liang J; Department of Radiology and Biomedical Imaging, University of California, 550 16th Street, San Francisco, CA 94158, USA.
  • Partridge SC; Department of Radiology, University of Washington, 1100 Fairview Ave N, Seattle, Washington, DC 98109, USA.
  • Price ER; Department of Radiology and Biomedical Imaging, University of California, 550 16th Street, San Francisco, CA 94158, USA.
  • Joe BN; Department of Radiology and Biomedical Imaging, University of California, 550 16th Street, San Francisco, CA 94158, USA.
  • Kornak J; Department of Epidemiology and Biostatistics, University of California, 550 16th Street, San Francisco, CA 94158, USA.
  • Magbanua MJM; Department of Laboratory Medicine, University of California, 2340 Sutter Street, San Francisco, CA 94115, USA.
  • Nanda R; Department of Medicine, University of Chicago, Chicago, IL 60637, USA.
  • LeStage B; I-SPY 2 Advocacy Group, 499 Illinois Street, San Francisco, CA 94158, USA.
  • Esserman LJ; Department of Surgery, University of California, 550 16th Street, San Francisco, CA 94158, USA.
  • I-Spy Imaging Working Group; Department of Radiology, University of Washington, 1100 Fairview Ave N, Seattle, Washington, DC 98109, USA.
  • I-Spy Investigator Network; Department of Radiology, University of Washington, 1100 Fairview Ave N, Seattle, Washington, DC 98109, USA.
  • Van't Veer LJ; Department of Laboratory Medicine, University of California, 2340 Sutter Street, San Francisco, CA 94115, USA.
  • Hylton NM; Department of Radiology and Biomedical Imaging, University of California, 550 16th Street, San Francisco, CA 94158, USA.
Cancers (Basel) ; 14(18)2022 Sep 13.
Article em En | MEDLINE | ID: mdl-36139594
ABSTRACT
This study tested the hypothesis that a change in the apparent diffusion coefficient (ADC) measured in diffusion-weighted MRI (DWI) is an independent imaging marker, and ADC performs better than functional tumor volume (FTV) for assessing treatment response in patients with locally advanced breast cancer receiving neoadjuvant immunotherapy. A total of 249 patients were randomized to standard neoadjuvant chemotherapy with pembrolizumab (pembro) or without pembrolizumab (control). DCE-MRI and DWI, performed prior to and 3 weeks after the start of treatment, were analyzed. Percent changes of tumor ADC metrics (mean, 5th to 95th percentiles of ADC histogram) and FTV were evaluated for the prediction of pathologic complete response (pCR) using a logistic regression model. The area under the ROC curve (AUC) estimated for the percent change in mean ADC was higher in the pembro cohort (0.73, 95% confidence interval [CI] 0.52 to 0.93) than in the control cohort (0.63, 95% CI 0.43 to 0.83). In the control cohort, the percent change of the 95th percentile ADC achieved the highest AUC, 0.69 (95% CI 0.52 to 0.85). In the pembro cohort, the percent change of the 25th percentile ADC achieved the highest AUC, 0.75 (95% CI 0.55 to 0.95). AUCs estimated for percent change of FTV were 0.61 (95% CI 0.39 to 0.83) and 0.66 (95% CI 0.47 to 0.85) for the pembro and control cohorts, respectively. Tumor ADC may perform better than FTV to predict pCR at an early treatment time-point during neoadjuvant immunotherapy.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Clinical_trials / Prognostic_studies / Risk_factors_studies Idioma: En Ano de publicação: 2022 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Clinical_trials / Prognostic_studies / Risk_factors_studies Idioma: En Ano de publicação: 2022 Tipo de documento: Article