9 months (HR = 0.00; 95% CI = 0.00-0.4; P = .001), respectively. qEASL (%) had the same responders based on target lesions and on overall response assessment; it showed

a trend but failed to reach statistical significance (P = .052; Table 6). Statistical analyses also showed that qEASL (cm3) had the highest value in predicting survival on its own (R2 = 79%). Among all the analyses that added a second predictor, GPCR Compound Library cell line the multivariate R2 was either lower than or equal to the one that had already been achieved by qEASL (cm3) alone (results not shown). The main finding of this study is that quantitative volumetric changes in tumor enhancement (qEASL) accurately predicted response to therapy and survival in patients with uveal melanoma after the first TACE. Survival is the ultimate marker for treatment efficacy in solid tumors, and radiologic objective response has been widely used and accepted as a surrogate end point to the survival-based end points traditionally used in clinical trials [9]. Because the prognosis of uveal melanoma MK-1775 nmr is highly dependent on disease progression in the liver, a local therapy holds promise in managing this otherwise highly chemoresistant disease. Hence, it is crucial to track the response to therapy early in the course of treatment to prevent a loss of chance for the patient. Our study showed that conventional response criteria

assessing anatomic changes in the tumor (WHO, RECIST, and vRECIST) failed to stratify patients according to the tumor response and to predict survival. Moreover, while achieving stratification between responders and non-responders, EASL and mRECIST failed to predict survival, while qEASL was the only criteria predictive of overall survival. These results collectively show that quantitative volumetric tumor response assessing viable tumor is the optimal tumor response criteria Farnesyltransferase in patients with metastatic uveal melanoma to the liver after the first session of TACE. This may be explained by the fact that conventional tumor response criteria that measure the tumor unidimensionally or bidimensionally wrongly assume that the tumor proportionally grows or shrinks in a spherical

manner. Indeed, unidimensional and bidimensional tumor response criteria presume that lesion diameter (RECIST), enhancing diameter (mRECIST), and the product of diameters (WHO) or enhancing diameters (EASL) correlate with the tumor volume. However, most liver tumors exhibit asymmetrical and heterogeneous pattern of necrosis that challenge precise tumor response assessment after chemoembolization [9]. However, by the nature of quantitative volumetric measurement methods such as qEASL, these limitations may be overcome. Indeed, qEASL has several methodological strengths: this approach utilizes a semiautomatic tumor segmentation that evaluates the entire tumor volume, including the viable enhancing as well as necrotic parts of the tumor.