Among 26 advanced HCC patients, 17 patients were responders by Choi criteria and had a significantly longer TTP compared with nonresponders. In RCC treated with anti angiogenic therapy, find FAQ another modified criteria called MASS criteria Inhibitors,Modulators,Libraries has been proposed, and de fine response as 20% diameter decrease, or 40HU density decrease, or marked central necrosis in predom inantly Inhibitors,Modulators,Libraries solid Inhibitors,Modulators,Libraries enhancing lesion. MASS criteria were recently studied in metastatic melanoma treated with bevacizumab with or without interferon, and shown to strongly predict progression free survival and OS. Given these prior observations and the recent promising phase 1 trial results, it is worthwhile to study tumor diameter and density changes, in addition to con ventional tumor diameter changes, during the combined therapy of ipilimumab and bevacizumab in capturing tumor response and predicting outcome.
The purpose of the study is to investigate the tumor diameter and density changes on CT in advanced Inhibitors,Modulators,Libraries melan oma patients treated with ipilimumab plus bevacizumab, compare response rates at the first follow up based on different response criteria incorporating tumor diame ters and density, and study association between these measures and survival. Results and discussion A total of 59 measurable lesions in 21 patients were included. Table 1 summa rizes demographics and disease characteristics of the 21 patients. There were 15 lung lesions, 14 peritoneal or retroperitoneal lesions, 11 liver, 9 subcutaneous, 5 nodes and 5 adrenal lesions. Lesion based analysis The median baseline diameter and density for the 59 lesions were 25 mm and 44.
9 HU. The median changes at the first follow up were 10. 7% for diameter, and ?9. 7% and ?2. 7HU for CT density. Figure 1 demonstrates the percent changes of diameter and density in 59 lesions. Table 2 summarizes the response by diameter and density of these lesions. No lesions met the density Inhibitors,Modulators,Libraries criteria by MASS, while 23 lesions met the Choi density criteria. When diameter and density changes were 13 patients with 2 or more lesions, discrepant CT density changes among lesions of the same patient was noted, with some lesions showing 15% density decrease and other lesions showing marked increase in density. Both patients met the response by Choi density criteria when the average density was used to represent the overall change.
Association with survival At the time of analysis, 14 patients had progressed and 6 patients had died. The median follow new up was 29. 7 months. combined, 4 lesions responded by RECIST, 9 lesions responded by MASS, and 29 lesions responded by Choi criteria. Patient based analysis The baseline sum diameter and average density and their changes on the first follow up scans are summarized in Table 1. Figure 2 demonstrates the percent changes of diameter and density in 21 patients. No patients met the density criteria by MASS, while 7 patients met density response criteria by Choi.