title: Correlating tumor metabolic progression index measured by serial FDG PET-CT, apparent diffusion coefficient measured by magnetic resonance imaging (MRI) and blood genomics to patient's outcome in advanced colorectal cancer: the CORIOLAN study.
abstract: BACKGROUND
  Metastatic colorectal cancer (mCRC) may present various behaviours that define different courses of tumor evolution. There is presently no available tool designed to assess tumor aggressiveness, despite the fact that this is considered to have a major impact on patient outcome.
  
  
  METHODS
  CORIOLAN is a single-arm prospective interventional non-therapeutic study aiming mainly to assess the natural tumor metabolic progression index (TMPI) measured by serial FDG PET-CT without any intercurrent antitumor therapy as a prognostic factor for overall survival (OS) in patients with mCRC.Secondary objectives of the study aim to test the TMPI as a prognostic marker for progression-free survival (PFS), to assess the prognostic value of baseline tumor FDG uptake on PFS and OS, to compare TMPI to classical clinico-biological assessment of prognosis, and to test the prognostic value on OS and PFS of MRI-based apparent diffusion coefficient (ADC) and variation of vADC using voxel-based diffusion maps.Additionally, this study intends to identify genomic and epigenetic factors that correlate with progression of tumors and the OS of patients with mCRC. Consequently, this analysis will provide information about the signaling pathways that determine the natural and therapy-free course of the disease. Finally, it would be of great interest to investigate whether in a population of patients with mCRC, for which at present no known effective therapy is available, tumor aggressiveness is related to elevated levels of circulating tumor cells (CTCs) and to patient outcome.
  
  
  CONCLUSIONS
  Tumor aggressiveness is one of the major determinants of patient outcome in advanced disease. Despite its importance, supported by findings reported in the literature of extreme outcomes for patients with mCRC treated with chemotherapy, no objective tool allows clinicians to base treatment decisions on this factor. The CORIOLAN study will characterize TMPI using FDG-PET-based metabolic imaging of patients with chemorefractory mCRC during a period of time without treatment. Results will be correlated to other assessment tools like DW-MRI, CTCs and circulating DNA, with the aim to provide usable tools in daily practice and in clinical studies in the future. ClinicalTrials.gov Number: NCT01591590.
authors.affiliation: Medicine Department, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium. amelie.deleporte@bordet.be.
authors.forename: Amelie
authors.initials: A
authors.lastname: Deleporte
authors.forename: Marianne
authors.initials: M
authors.lastname: Paesmans
authors.forename: Camilo
authors.initials: C
authors.lastname: Garcia
authors.forename: Caroline
authors.initials: C
authors.lastname: Vandeputte
authors.forename: Marc
authors.initials: M
authors.lastname: Lemort
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Engelholm
authors.forename: Frederic
authors.initials: F
authors.lastname: Hoerner
authors.forename: Philippe
authors.initials: P
authors.lastname: Aftimos
authors.forename: Ahmad
authors.initials: A
authors.lastname: Awada
authors.forename: Nicolas
authors.initials: N
authors.lastname: Charette
authors.forename: Godelieve
authors.initials: G
authors.lastname: Machiels
authors.forename: Martine
authors.initials: M
authors.lastname: Piccart
authors.forename: Patrick
authors.initials: P
authors.lastname: Flamen
authors.forename: Alain
authors.initials: A
authors.lastname: Hendlisz
mesh_terms: D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000378:metabolism* / Q000473:pathology; D038524:Diffusion Magnetic Resonance Imaging; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009360:Neoplastic Cells, Circulating; D049268:Positron-Emission Tomography; D011379:Prognosis; D016896:Treatment Outcome
chemical_list: D019788:Fluorodeoxyglucose F18