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- W81008075 abstract "9005 Background: Criteria for tumor response that rely on changes in size may underestimate the true response rate in soft tissue sarcomas (STS). We report an interim analysis of a prospective study to compare STS response by RECIST and FDG PET after 2 and 4 cycles of doxorubicin and ifosfamide (A/I) with histologic response after 4 cycles of A/I. Methods: Patients with localized, high-grade STS received 4 cycles of neoadjuvant A/I, tumor resection, 2 cycles of adjuvant A/I and radiation. A MRI or CT scan and FDG PET scan of the STS were done at diagnosis, after 2 and 4 cycles of A/I. Histologic response was determined after the 4th cycle of A/I unless the sarcoma was progressive unequivocally after the 2nd cycle. Response was dichotomized into good vs poor, respectively, as follows: RECIST (complete or partial response vs stable or progressive disease), FDG PET (≥ vs < 40% decline in the tumor maximum standardized uptake value (SUV)) and histology (≤ vs > 10% residual viable tumor). McNemar’s test of dependent proportions was used to determine agreement between methods of response assessment. Results: STS was resected after 2 cycles of A/I in 8 patients because of disease progression and resected after 4 cycles of A/I in 33 patients. All 8 of the sarcomas resected after 2 cycles showed poor histologic response and an increase in the tumor SUV (n=5) or progression by RECIST (n=3). Among 11 patients with a good histologic response, 8 had a good PET response and 1 a response by RECIST. Among 30 patients with a poor histologic response, 20 had a poor PET response and 30 did not have a response by RECIST. Response assessment by FDG PET after the 2nd and 4th cycles was similar. RECIST response after the 2nd cycle of A/I and histologic response were not in agreement (P=0.002), whereas the FDG PET response after the 2nd cycle of A/I did not disagree with histologic response (P=0.092). Conclusions: RECIST is not indicative of histologic response in high-grade STS treated with A/I. Response by FDG PET after 2 cycles of A/I may provide evidence of drug activity. This study is ongoing and will evaluate relationships between FDG PET, RECIST and histologic responses and outcome. Supported by NIH/NCI CA 65537. No significant financial relationships to disclose." @default.
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- W81008075 date "2005-06-01" @default.
- W81008075 modified "2023-10-14" @default.
- W81008075 title "FDG PET but not RECIST agrees with histologic response of soft tissue sarcoma to neoadjuvant chemotherapy" @default.
- W81008075 doi "https://doi.org/10.1200/jco.2005.23.16_suppl.9005" @default.
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