scholarly journals Treatment response to cyclophosphamide, rituximab, and bortezomib in chronic immune-mediated sensorimotor neuropathies: a retrospective cohort study

2021 ◽  
Vol 14 ◽  
pp. 175628642199963
Author(s):  
Jeremias Motte ◽  
Anna Lena Fisse ◽  
Nuray Köse ◽  
Thomas Grüter ◽  
Hannah Mork ◽  
...  
Keyword(s):  
Treatment Response ◽  
Response Rate ◽  
Response To Therapy ◽  
First Line ◽  
Disability Score ◽  
Disease Characteristics ◽  
Immune Mediated ◽  
Inflammatory Neuropathy ◽  
Long Term Follow Up ◽  
Late Treatment

Background: Up to 20% of patients with chronic immune-mediated sensorimotor neuropathies (CIN) do not respond adequately to first-line therapies. However, studies on further treatment are scarce. Methods: We analyzed retrospectively 200 CIN patients regarding disease characteristics and response to therapy with cyclophosphamide (CYP), rituximab (RTX), and bortezomib (BTZ). Treatment response was defined as improvement or stabilization of inflammatory neuropathy cause and treatment overall disability score (INCAT-ODSS). Results: A total of 48 of 181 patients (26.5%) received therapy with CYP, RTX, or BTZ. The most frequently and first used therapy was CYP (69%). More than 40% of patients needed a second or third treatment. Overall, 71 treatments were applied in 48 patients. The combination of up to all three treatments enhanced the response-rate to 90%. Treatment within 24 months after initial diagnosis resulted in significantly higher response rate than late treatment (79% versus 50 %, p = 0.04, χ2-test, n = 46) and in lower disability in long-term follow up (INCAT-ODSS 3.8 versus 5.8, p = 0.02, t-test, n = 48). Patients with Lewis-Sumner syndrome ( n = 9) and autoantibody mediated neuropathies ( n = 13) had excellent response rates after treatment with RTX (90–100%). In contrast, typical chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) showed a response rate of 64% in CYP, 64% in RTX, and 75% in BTZ. Conclusion: Treatment with CYP, RTX, or BTZ was effective in this cohort of CIN refractory to first-line treatment. Our data increase evidence for an early use of these therapies. High efficacy of RTX in Lewis-Sumner syndrome in contrast to typical CIDP suggests a distinct pathophysiology.

Markers of Responsiveness to ATG/CsA Therapy in Patients with Severe Aplastic Anemia.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 1699-1699
Author(s):  
Abdo S. Haddad ◽  
Ania Jankowska ◽  
Theodore Ghazal ◽  
Sandra Smieszek ◽  
Ramon Tiu ◽  
...  
Keyword(s):  
Stem Cell ◽  
T Cell ◽  
Overall Response Rate ◽  
Response Rate ◽  
First Line ◽  
Cd8 Cells ◽  
Overall Response ◽  
Flow Cytometric ◽  
Cell Clones ◽  
Immune Mediated

Abstract While ATG/CsA therapy results in a significant response rate in severe aplastic anemia (sAA), a substantial minority of patient remains refractory. Lack of response to intense immunosuppression (IS) may be a consequence of “non -immune” pathogenesis or be due inadequate intensity/duration of IS or exhaustion of stem cell reserves. Identification of markers of IS responsiveness would allow for a better patient selection and early application of stem cell transplantation (SCT). Various parameters of immune activation have been investigated but suitable makers of responsiveness to IS were not identified. Previously, we have shown a potential utility of flow cytometric analysis of T cell VB repertoire to identify expanded T cell clones that are involved in the autoimmune attack on hematopoietic progenitor and stem cells in immune-mediated bone marrow failure. Among 110 AA cases treated in our institution, 88 had sAA; 12 of them underwent early SCT while 74 were initially treated ATG/CsA. Of those patients, 60 received equine ATG (H-ATG) as a primary (N=56), or salvage modality (N=4) after rabbit ATG (R-ATG) with overall response rate (defined by transfusion independence and not fulfilling severity criteria) of 65% (66% as a first line). R-ATG was used in 23 patients as an initial (N=15) or salvage treatment (N=7) with overall response rate of 60% (61% as a first line, P=.88 as compared to H-ATG). For 24 patients (3 with mAA) we performed serial flow cytometric VB utilization profiling within CD3 CD4 and CD8 cells. All of these patients were minimally transfused and not infected at the time of initial testing. Prior to therapy, VB expansions (≥2 VB families) within CD4 and CD8 cells (defined as >mean+2xSD value for a given VB family in controls) indicative of the presence of potentially pathogenic T cell clones were present in 7/21 and 13/21 patients, respectively, P=.26. Nominally, CD4 and CD8 VB overrepresentations were 7% >mean+2xSD (1.7%-17.3%) and 9.26% (1.8%-24.5%), respectively. Within this specific sub-cohort of patients, the overall response rate measured at 6 months was 14/19 (73%). Response correlated with the presence of VB expansions prior to therapy; responders showed on average more and larger CD8 expansions (2 VB/patient, 0–3; 6.16% av. size, 1.8%-24.5%) and larger expansions vs. lower number of and smaller CD8 expansions (0.6 VB/patient, 0–3; 1.7% av. size, 5.7–11.4%) were seen in refractory patients (only 1/5 refractory patients had VB expansions). Conversely, 10/14 (71%) responses were seen in patients in with ≥2 CD8 VB expansion, only 1 patient responded but had no CD8 VB expansions. In contrast, only 1/5 (20%) ≥2 CD8 VB expansion were seen in refractory patients. Remarkably, hematologic improvement was associated with resolution of at least one significant VB expansion during monthly evaluations. In patients who relapsed reappearance of the original or new VB expansion within CD8 cells was seen. We conclude that CD8 VB expansions involving ≥2 VB families may predict of subsequent response to IS suggesting that VB typing may be a suitable monitoring tool for patients with immune-mediated AA.

scholarly journals A Rare but Fascinating Disorder: Case Collection of Patients with Schnitzler Syndrome

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Maaman Bashir ◽  
Brittany Bettendorf ◽  
Richard Hariman
Keyword(s):  
Interleukin 1 ◽  
Response To Therapy ◽  
Rare Disorder ◽  
First Line ◽  
First Line Therapy ◽  
Schnitzler Syndrome ◽  
Long Term Follow Up ◽  
Case Collection

Background. Schnitzler syndrome is a rare disorder characterized by a chronic urticarial rash and monoclonal gammopathy (IgM in more than 90% of the cases). It is difficult to distinguish from other neutrophilic urticarial dermatoses, and diagnosis is based on the Strasbourg criteria. Interleukin-1 is considered the key mediator, and interleukin-1 inhibitors are considered first line treatment. Here, we present two cases of Schnitzler syndrome, both successfully treated with anakinra. Objectives. To increase awareness regarding clinical presentation, diagnosis, and treatment of this rare disorder. Cases. We describe the clinical features and disease course of two patients with Schnitzler syndrome, diagnosed using the Strasbourg criteria. Both were treated with anakinra with remarkable response to therapy. Conclusion. Schnitzler syndrome is a rare and underdiagnosed disorder. High suspicion should be maintained in patients with chronic urticaria-like dermatoses, intermittent fevers, and arthralgias. A serum protein electrophoresis and immunofixation should be performed in these patients. The diagnosis is important to recognize as Schnitzler syndrome is associated with malignancy. A lymphoproliferative disorder develops in about 20% of patients at an average of 7.6 years after onset of symptoms. Thus, patients warrant long-term follow-up. IL-1 inhibitors are extremely effective in relieving symptoms and are considered first line therapy.

Subcutaneous Alemtuzumab Is a Safe and Effective Treatment for Global or Single-Lineage Immune-Mediated Marrow Failures: a Survey from the EBMT-WPSAA

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 1042-1042
Author(s):  
Antonio M. Risitano ◽  
Elisa Seneca ◽  
Ludovica Marando ◽  
Bianca Serio ◽  
Carmine Selleri ◽  
...  
Keyword(s):  
Total Dose ◽  
Viral Infections ◽  
Response Rate ◽  
Bone Marrow Failure ◽  
Prospective Trial ◽  
Underlying Disease ◽  
Hbv Reactivation ◽  
First Line ◽  
Immune Mediated

Abstract Acquired marrow failure syndromes may globally affect all hematopoietic lineages, as in aplastic anemia (AA), or may selectively involve single lineages, as in pure red cell (PRCA) or in pure white cell aplasias (PWCA). Because of their common cellular immune-mediated pathophysiology, standard treatment for these conditions includes immunosuppression (IS), which may differ according to the specific disease. We investigated an experimental IS regimen based on the anti-CD52 antibody alemtuzumab (MabCampath®, ALE); the study included a phase II/III prospective trial, as well as a collection of retrospective cases. A total of 32 patients have been treated by ALE (18 SAA, 10 PRCA and 4 PWCA), fourteen of them (mostly PRCA) having not received previous IS. The most utilized schedule (as defined in the prospective trial) was 3,10,30,30,30 mg (total dose 103), administered subcutaneously in consecutive days, with adequate premedication; the last dose was amended in PRCA and PWCA patients (total dose 73 mg). In the prospective trial, all patients also received oral low dose cyclosporine A (1 mg/kg) from day 7, and an intensive anti-infectious prophylaxis, which included oral valgancyclovir and cotrimoxazol. All patients completed the treatment with unrelevant injection-related side effect (fever and/or rash in some cases) and absence of laboratory abnormalities. Complete lympho-ablation was observed in all patients within 2–3 days, which persisted for several weeks; transient worsening of neutropenia and/or thrombocytopenia were observed in some cases. The median follow up was 12 months; there were 5 deaths, only one was possibly related to the treatment. In the prospective trial (n=23), infectious events were rare: a single FUO, associated with fatal complication of an underlying atrial fibrillation, other four viral infections (1 VZV with shingles, 2 HSV and 1 flu), all resolving quickly. No CMV or EBV disease was observed, even if 3 border-line CMV reactivations were documented (after discontinuation of the antiviral prophylaxis), promptly resolved by preemptive valganciclovir. One HBV reactivation without hepatitis required lamivudine. The response rate was globally 61% (42% CR and 19% PR), which raised to 73% (50% CR and 23% PR) when only patients with a follow up of at least 4 months were considered. In the more homogeneous cohort of the prospective trial, response rate was analyzed according to the underlying disease. Among 10 AA treated (5 as first line), 7 had an adequate follow up and showed 4 CR (57%) and 2 PR (29%). Response rate was even higher in 10 PRCA (8 as first line): 7 were evaluable for response, with 5 CR (71%) and 1 PR (14%); the 1 non responding patient subsequently showed evolution to MDS. Finally, 2 of 3 PWCA achieved a CR (66%), with the remaining showing early progression to MDS. Among the responding patients, relapses were quite frequent, even while on cyclosporine: 3/6 SAAs, 5/6 PRCAs and 1/2 PWCA. Relapses were successfully treated by additional ALE (as single shoots or complete courses). Immune reconstitution was delayed up to several months, especially affecting the CD4+ compartment; this was also due to additional ALE needed to treat or to prevent relapses. In conclusion, subcutaneous ALE is a feasible and safe IS regimen for patients suffering from immune-mediated marrow failure syndromes. Preliminary results suggest excellent efficacy, even if responses may be quite late (3–4 months); relapses often occur, but can be easily managed by ALE retreatment. ALE is an excellent alternative to standard IS regimen, and deserves systematic investigation in bone marrow failure patients.

KRAS mutation status to predict response in first-line capox and bevacizumab therapy for metastatic colorectal cancer.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 536-536
Author(s):  
You Yone ◽  
Mohammad Abdallah ◽  
Saad Sabih Tahir ◽  
Selim Cellek ◽  
Jufen Zhang ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Metastatic Colorectal Cancer ◽  
Treatment Response ◽  
Response Rate ◽  
Quantitative Polymerase Chain Reaction ◽  
Tumour Response ◽  
Ffpe Tissue ◽  
First Line ◽  
Large Patient ◽  
Kras Status

536 Background: Capecitabine and Oxaliplatin (CAPOX) combined with the humanised anti-vascular endothelial growth factor Bevacizumab represents a standard first-line treatment for metastatic colorectal cancer (mCRC). However, the response rate is only approximately 50% and currently there is no biomarker to predict treatment response. This study aims to correlate KRAS status with response to CAPOX and Bevacizumab (CAPOX-Bev). Methods: Forty-five patients with mCRC were retrospectively screened between January 2012 and December 2015 at Broomfield Hospital, UK. DNA was extracted from formalin-fixed paraffin-embedded (FFPE) tissue samples (Qiagen FFPE tissue kit). Twelve types of mutations in Exons 2, 3 and 4 of the KRAS gene were analysed using a real-time quantitative polymerase chain reaction (qPCR) assay (EntroGen). Treatment response was assessed according to RECIST criteria version 1.1 by comparing pre-treatment and post-treatment radiological CT scans. The KRAS status was correlated with CT tumour response (responders: partial response and complete response; non-responders: progressive disease and stable disease). A Chi-square test was used to determine the correlation between KRAS status and tumour response. Results: 19/45 patients were KRAS wild type (WT, 42%) and 26 were KRAS mutant (MT, 58%). 8/19 (42%) KRAS WT patients were responders, compared to 3/26 (12%) KRAS MT patients. Conversely 11/19 (58%) of WT patients were non-responders, compared to 23/26 (88%) MT patients. The correlation of treatment response and KRAS status was statistically significant (p = 0.018), with a 31% difference in response rate between KRAS WT (42%) and KRAS MT (12%) groups. Conclusions: Within this pilot retrospective analysis, KRAS mutations demonstrated clinical value in identifying patients who are more likely to respond to first-line CAPOX-Bev in advanced colorectal cancer. This finding requires prospective evaluation within a large patient cohort powered to further detect potential differences in overall and progression free survival. [Table: see text]

scholarly journals Bempegaldesleukin Plus Nivolumab in First-Line Metastatic Melanoma

2021 ◽  
pp. JCO.21.00675
Author(s):  
Adi Diab ◽  
Scott S. Tykodi ◽  
Gregory A. Daniels ◽  
Michele Maio ◽  
Brendan D. Curti ◽  
...  
Keyword(s):  
Adverse Events ◽  
Metastatic Melanoma ◽  
Response Rate ◽  
Objective Response ◽  
Progression Free Survival ◽  
First Line ◽  
Free Survival ◽  
Median Progression Free Survival ◽  
Immune Mediated ◽  
Grade 3

PURPOSE Therapies that produce deep and durable responses in patients with metastatic melanoma are needed. This phase II cohort from the international, single-arm PIVOT-02 study evaluated the CD122-preferential interleukin-2 pathway agonist bempegaldesleukin (BEMPEG) plus nivolumab (NIVO) in first-line metastatic melanoma. METHODS A total of 41 previously untreated patients with stage III/IV melanoma received BEMPEG 0.006 mg/kg plus NIVO 360 mg once every 3 weeks for ≤ 2 years; 38 were efficacy-evaluable (≥ 1 postbaseline scan). Primary end points were safety and objective response rate (blinded independent central review); other end points included progression-free survival, overall survival (OS), and exploratory biomarkers. RESULTS At 29.0 months' median follow-up, the objective response rate was 52.6% (20 of 38 patients), and the complete response rate was 34.2% (13 of 38 patients). Median change in size of target lesions from baseline was −78.5% (response-evaluable population); 47.4% (18 of 38 patients) experienced complete clearance of target lesions. Median progression-free survival was 30.9 months (95% CI, 5.3 to not estimable). Median OS was not reached; the 24-month OS rate was 77.0% (95% CI, 60.4 to 87.3). Grade 3 and 4 treatment-related and immune-mediated adverse events occurred in 17.1% (7 of 41) and 4.9% (2 of 41) of patients, respectively. Increased polyfunctional responses in CD8+ and CD4+ T cells were seen in blood after treatment, driven by cytokines with effector functions. Early on-treatment blood biomarkers (CD8+ polyfunctional strength difference and eosinophils) correlated with treatment response. CONCLUSION BEMPEG in combination with NIVO was tolerated, with relatively low rates of grade 3 and 4 treatment-related and immune-mediated adverse events. The combination had encouraging antitumor activity in first-line metastatic melanoma, including an extended median progression-free survival. Exploratory analyses associated noninvasive, on-treatment biomarkers with response, before radiologic evidence was observed.

New therapeutic approaches for polymyositis and dermatomyositis

2011 ◽  
Vol 152 (39) ◽  
pp. 1552-1559 ◽  
Author(s):  
Katalin Dankó ◽  
Melinda Vincze
Keyword(s):  
Immunosuppressive Agents ◽  
Inflammatory Myopathy ◽  
Proximal Muscle ◽  
Therapeutic Approaches ◽  
First Line ◽  
New Therapeutic Approaches ◽  
Remission Period ◽  
Immune Mediated ◽  
Systemic Manifestations ◽  
Line Of Therapy

Inflammatory myopathies are chronic, immune-mediated diseases characterized with progressive proximal muscle weakness. They encompass a variety of syndromes with protean manifestations. The aims of therapy are to increase muscle strength, prevent the development of contractures, and to manage the systemic manifestations of the disease. This is a complex treatment which requires routine and wide knowledge. The most important task is to recognize the disease and guide the patient to immunologic center. Although the first line of therapy continues to include corticosteroids, there are a multitude of agents available for treating patients with myositis. There are several different immunosuppressive agents which may be applied alone or in combination with each other, as well as an increasing number of novel and exciting biologic agents targeting molecules participating in the pathogenesis of inflammatory myopathy. Physiotherapy and rehabilitation in the remission period may significantly improve the functional outcome of patients with these disorders. Orv. Hetil., 2011, 152, 1552–1559.

LI-RADS treatment response algorithm after first-line DEB-TACE: reproducibility and prognostic value at initial post-treatment CT/MRI

2021 ◽  
Author(s):  
Ali Pirasteh ◽  
E. Aleks Sorra ◽  
Hector Marquez ◽  
Robert C. Sibley ◽  
Julia R. Fielding ◽  
...  
Keyword(s):  
Treatment Response ◽  
Prognostic Value ◽  
Post Treatment ◽  
First Line

scholarly journals Autoimmune Hemolytic Anemia as a Complication of Congenital Anemias. A Case Series and Review of the Literature

2021 ◽  
Vol 10 (15) ◽  
pp. 3439
Author(s):  
Irene Motta ◽  
Juri Giannotta ◽  
Marta Ferraresi ◽  
Kordelia Barbullushi ◽  
Nicoletta Revelli ◽  
...  
Keyword(s):  
Hemolytic Anemia ◽  
Autoimmune Hemolytic Anemia ◽  
Case Series ◽  
Intravenous Immunoglobulins ◽  
Point Of View ◽  
First Line ◽  
Human Erythropoietin ◽  
Immune Mediated ◽  
Hemolytic Crisis ◽  
Life Threatening

Congenital anemias may be complicated by immune-mediated hemolytic crisis. Alloantibodies are usually seen in chronically transfused patients, and autoantibodies have also been described, although they are rarely associated with overt autoimmune hemolytic anemia (AIHA), a serious and potentially life-threatening complication. Given the lack of data on the AIHA diagnosis and management in congenital anemias, we retrospectively evaluated all clinically relevant AIHA cases occurring at a referral center for AIHA, hemoglobinopathies, and chronic hemolytic anemias, focusing on clinical management and outcome. In our cohort, AIHA had a prevalence of 1% (14/1410 patients). The majority were warm AIHA. Possible triggers were recent transfusion, infection, pregnancy, and surgery. All the patients received steroid therapy as the first line, and about 25% required further treatment, including rituximab, azathioprine, intravenous immunoglobulins, and cyclophosphamide. Transfusion support was required in 57% of the patients with non-transfusion-dependent anemia, and recombinant human erythropoietin was safely administered in one third of the patients. AIHA in congenital anemias may be challenging both from a diagnostic and a therapeutic point of view. A proper evaluation of hemolytic markers, bone marrow compensation, and assessment of the direct antiglobulin test is mandatory.

scholarly journals Myocarditis-associated necrotizing coronary vasculitis: incidence, cause, and outcome

2020 ◽  
Author(s):  
Andrea Frustaci ◽  
Maria Alfarano ◽  
Romina Verardo ◽  
Chiara Agrati ◽  
Rita Casetti ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Hypereosinophilic Syndrome ◽  
Left Ventricular ◽  
Response To Therapy ◽  
Left Ventricular Ejection ◽  
Toll Like Receptor ◽  
Toll Like Receptor 4 ◽  
Ventricular Ejection Fraction ◽  
Immune Mediated ◽  
Coronary Vasculitis

Abstract Aims  Necrotizing coronary vasculitis (NCV) is a rare entity usually associated to myocarditis which incidence, cause, and response to therapy is unreported. Methods and results  Among 1916 patients with biopsy-proven myocarditis, 30 had NCV. Endomyocardial samples were retrospectively investigated with immunohistochemistry for toll-like receptor 4 (TLR4) and real-time polymerase chain reaction (PCR) for viral genomes. Serum samples were processed for anti-heart autoantibodies (Abs), IL-1β, IL-6, IL-8, tumour necrosis factor (TNF)-α. Identification of an immunologic pathway (including virus-negativity, TLR4-, and Ab-positivity) was followed by immunosuppression. Myocarditis-NCV cohort was followed for 6 months with 2D-echo and/or cardiac magnetic resonance and compared with 60 Myocarditis patients and 30 controls. Increase in left ventricular ejection fraction ≥10% was classified as response to therapy. Control endomyocardial biopsy followed the end of treatment. Twenty-six Myocarditis-NCV patients presented with heart failure; four with electrical instability. Cause of Myocarditis-NCV included infectious agents (10%) and immune-mediated causes (chest trauma 3%; drug hypersensitivity 7%; hypereosinophilic syndrome 3%; primary autoimmune diseases 33%, idiopathic 44%). Abs were positive in immune-mediated Myocarditis-NCV and virus-negative Myocarditis; Myocarditis-NCV patients with Ab+ presented autoreactivity in vessel walls. Toll-like receptor 4 was overexpressed in immune-mediated forms and poorly detectable in viral. Interleukin-1β was significantly higher in Myocarditis-NCV than Myocarditis, the former presenting 24% in-hospital mortality compared with 1.5% of Myocarditis cohort. Immunosuppression induced improvement of cardiac function in 88% of Myocarditis-NCV and 86% of virus-negative Myocarditis patients. Conclusion  Necrotizing coronary vasculitis is histologically detectable in 1.5% of Myocarditis. Necrotizing coronary vasculitis includes viral and immune-mediated causes. Intra-hospital mortality is 24%. The immunologic pathway is associated with beneficial response to immunosuppression.

Influence of Baseline Positron Emission Tomography in Metastatic Gastroesophageal Cancer on Survival and Response to Therapy

Oncology ◽  
2021 ◽  
pp. 1-6
Author(s):  
Ahmed Abdelhakeem ◽  
Madhavi Patnana ◽  
Xuemei Wang ◽  
Jane E. Rogers ◽  
Mariela Blum Murphy ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Response To Therapy ◽  
Emission Tomography ◽  
Gastroesophageal Cancer ◽  
First Line ◽  
First Line Therapy ◽  
Line Therapy ◽  
Positron Emission ◽  
Pet Ct ◽  
Metastatic Burden

<b><i>Background:</i></b> The value of baseline fluorodeoxyglucose-positron emission tomography-computed tomography (PET-CT) remains uncertain once gastroesophageal cancer is metastatic. We hypothesized that assessment of detailed PET-CT parameters (maximum standardized uptake value [SUVmax] and/or total lesion glycolysis [TLG]), and the extent of metastatic burden could aid prediction of probability of response or prognosticate. <b><i>Methods:</i></b> We retrospectively analyzed treatment-naive patients with stage 4 gastroesophageal cancer (December 2002–August 2017) who had initial PET-CT for cancer staging at MD Anderson Cancer Center. SUVmax and TLG were compared with treatment outcomes for the full cohort and subgroups based on metastatic burden (≤2 or &#x3e;2 metastatic sites). <b><i>Results:</i></b> We identified 129 patients with metastatic gastroesophageal cancer who underwent PET-CT before first-line therapy. The median follow-up time was 61 months. The median overall survival (OS) was 18.5 months; the first progression-free survival (PFS) was 5.5 months. SUVmax or TLG of the primary tumor or of all metastases combined had no influence on OS or PFS, whether the number of metastases was ≤2 or &#x3e;2. Overall response rates (ORRs) to first-line therapy were 48% and 45% for patients with ≤2 and &#x3e;2 metastases, respectively (nonsignificant). ORR did not differ based on low or high values of SUVmax or TLG. <b><i>Conclusions:</i></b> This is the first assessment of a unique set of PET-CT data and its association with outcomes in metastatic gastroesophageal cancer. In our large cohort of patients, detailed analyses of PET-CT (by SUVmax and/or TLG) did not discriminate any parameters examined. Thus, baseline PET-CT in untreated metastatic gastroesophageal cancer patients has limited or no utility.

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