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Open Access Study protocol

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

Amelie Deleporte1*, Marianne Paesmans2, Camilo Garcia3, Caroline Vandeputte1, Marc Lemort4, Jean-Luc Engelholm4, Frederic Hoerner1, Philippe Aftimos1, Ahmad Awada1, Nicolas Charette1, Godelieve Machiels1, Martine Piccart1, Patrick Flamen3 and Alain Hendlisz1

Author Affiliations

1 Medicine Department, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium

2 Data Centre, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium

3 Nuclear Medicine Department, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium

4 Radiology Department, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium

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BMC Cancer 2014, 14:385  doi:10.1186/1471-2407-14-385

Published: 30 May 2014

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/Design

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.

Discussion

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.

Clinical trials.gov number

NCT01591590.

Keywords:
Colorectal cancer; Progression rate assessment; FDG-PET; PET/CT