Clinical and biochemical predictors of tumor response after neoadjuvant therapy in rectal cancer

Bedrikovetski, Sergei; Traeger, Luke; Vather, Ryash; Moore, James W.; Sammour, Tarik

doi:10.1111/ajco.13877

Cited by 3 publications

(1 citation statement)

References 40 publications

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“…Domestic studies also suggested that TNT did not significantly improve the survival prognosis of rectal cancer patients. A subgroup analysis of several studies showed that the OS and DFS of pCR patients were much better than those of nonpCR patients[ 43 , 44 ]. This suggests that the survival prognosis of rectal cancer patients may be linked to local tumor control.…”

Section: Discussionmentioning

confidence: 99%

Compare clinical efficacy and safety of neoadjuvant therapy and neoadjuvant chemoradiotherapy for locally advanced rectal cancer: Meta-analysis

Wang,

Yang,

Liu

et al. 2024

World J Gastrointest Surg

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BACKGROUND To compare the efficacy and safety of total neoadjuvant therapy (TNT) and neoadjuvant chemoradiotherapy (nCRT) in the treatment of middle and low locally advanced rectal cancer. Our study will systematically collect and integrate studies to evaluate the ability of these two treatments to improve tumor shrinkage rates, surgical resection rates, tumor-free survival, and severe adverse events. AIM To provide clinicians and patients with more reliable treatment options to optimize treatment outcomes and quality of life for patients with locally advanced rectal cancer by comparing the advantages and disadvantages of the two treatment options. METHODS A full search of all clinical studies on the effectiveness and safety of TNT and nCRT for treating locally advanced rectal cancer identified in Chinese (CNKI, Wanfang, China Biomedical Literature Database) and English (PubMed, Embase) databases was performed. Two system assessors independently screened the studies according to the inclusion and exclusion criteria. Quality evaluation and data extraction were performed for the included literature. We used RevMan 5.3 software to perform a meta-analysis of the pathologic complete response (pCR) rate, T stage degradation rate, resection 0 (R0) rate, anal grade 3/4 acute toxicity rate, perioperative complications, overall survival (OS), and disease-free survival (DFS) in the TNT and nCRT groups. RESULTS Finally, 14 studies were included, six of which were randomized controlled studies. A total of 3797 patients were included, including 1865 in the TNT group and 1932 in the nCRT group. The two sets of baseline data were comparable. The results of the meta-analysis showed that the pCR rate [odds ratio (OR) = 1.57, 95% confidence interval (CI): 1.30-1.90, P < 0.00001], T stage degradation rate (OR = 2.16, 95%CI: 1.63-2.57, P < 0.00001), and R0 resection rate (OR = 1.42, 95%CI: 1.09-1.85, P = 0.009) were significantly greater in the nCRT group than in the nCRT group. There was no significant difference in the incidence of grade 3/4 acute toxicity or perioperative complications between the two groups. The 5-year OS [hazard ratio (HR) = 0.84, 95%CI: 0.69-1.02, P = 0.08] and DFS (HR = 0.94, 95%CI: 0.03-1.39, P = 0.74) of the TNT group were similar to those of the nCRT group. CONCLUSION TNT has greater clinical efficacy and safety than nCRT in the treatment of locally advanced rectal cancer.

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Section: Discussionmentioning

confidence: 99%

Compare clinical efficacy and safety of neoadjuvant therapy and neoadjuvant chemoradiotherapy for locally advanced rectal cancer: Meta-analysis

Wang,

Yang,

Liu

et al. 2024

World J Gastrointest Surg

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Association Between RAS/BRAF Mutations and Complete Response Following Total Neoadjuvant Therapy in Patients with Rectal Cancer: A Prospective Multicentered Study

Bedrikovetski,

Traeger,

Fitzsimmons

et al. 2023

Ann Surg Oncol

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Influencing factors and establishment of a prediction model for the efficacy of neoadjuvant chemoradiotherapy in locally advanced rectal cancer

Liu

Chen

et al. 2023

Preprint

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Purpose To analyze the influencing factors of neoadjuvant chemoradiotherapy for locally advanced rectal cancer and construct an efficacy prediction model. Methods A total of 158 LARC patients who underwent total mesenteric excision after receiving neoadjuvant chemoradiotherapy treatment at the First Hospital Affiliated to Air Force Medical University from January 2016 to December 2020 were enrolled. Baseline clinical indicators before neoadjuvant therapy were collected, including laboratory data, tumor markers and MRI. The efficacy prediction model was constructed through the R language, the predictive performance of the model was evaluated using DCA curves and calibration curves, and the accuracy of the model was tested through 10-fold cross-validation. Results Ninety-eight patients achieved complete response (CR) or partial response (PR), with an overall response rate was 62%. Sixty patients had a poor neoadjuvant chemoradiotherapy response, either stable disease (SD) or progressive disease (PD). Pretreatment tumor diameter, time to surgery after neoadjuvant therapy, D-dimer, Prognostic Nutritional Index (PNI), carcinoembryonic antigen (CEA), and extramural vascular invasion (EMVI) were included in the prediction model. The area under the ROC curve (AUC) of the LARC neoadjuvant radiotherapy prediction model was 0.84 (95% CI: 0.780–0.899), with a sensitivity of 85% and a specificity of 72%.In the calibration curve, the predicted results are in good agreement with the actual results, with good prediction accuracy; the DCA curve shows that the efficacy prediction model can bring clinical net benefit to diagnosis. Conclusion Pretreatment tumor diameter, time to surgery after neoadjuvant therapy, D-dimer, PNI, CEA and EMVI are independent risk factors for the efficacy of neoadjuvant chemoradiotherapy in LARC patients. The efficacy prediction model based on the above factors has good predictive efficacy for the efficacy of neoadjuvant chemoradiotherapy in LARC patients.

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Clinical and biochemical predictors of tumor response after neoadjuvant therapy in rectal cancer

Cited by 3 publications

References 40 publications

Compare clinical efficacy and safety of neoadjuvant therapy and neoadjuvant chemoradiotherapy for locally advanced rectal cancer: Meta-analysis

Compare clinical efficacy and safety of neoadjuvant therapy and neoadjuvant chemoradiotherapy for locally advanced rectal cancer: Meta-analysis

Association Between RAS/BRAF Mutations and Complete Response Following Total Neoadjuvant Therapy in Patients with Rectal Cancer: A Prospective Multicentered Study

Influencing factors and establishment of a prediction model for the efficacy of neoadjuvant chemoradiotherapy in locally advanced rectal cancer

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