Integration of stereotactic radiotherapy in the treatment of metastatic colorectal cancer patients: a real practice study with long-term outcome and prognostic factors

Ottaiano, Alessandro; Scotti, V.; Divitiis, Chiara De; Capozzi, Monica; Romano, Carmen; Cassata, Antonino; Casaretti, Rossana; Silvestro, Lucrezia; Nappi, Anna; Vicario, Valeria; Stefano, Alfonso De; Tafuto, Salvatore; Berretta, Massimiliano; Nasti, Guglielmo; Avallone, Antonio

doi:10.18632/oncotarget.25834

Cited by 6 publications

(10 citation statements)

References 35 publications

(27 reference statements)

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“…19,23,[25][26][27][28] Total number of metastases treated with SABR was not a clear prognostic factor according to our analysis. Limited number (< 3) of metastases improved LC in one study 29 and OS in two. 22,28 In a retrospective study LC was significantly better for pulmonary oligometastases from rectal cancer compared to those from colon cancer.…”

Section: Sabr-related Predictors Of Response In Primary Tumor-specific Oligometastatic Disease Colorectal Cancermentioning

confidence: 90%

“…Furthermore, Jingu et al showed in multivariate analysis that chemotherapy after SABR improved LC in pulmonary oligometastatic disease from CRC. 17 29 Li et al reported a correlation between radiological response to CT-scan and OS after SABR. The first radiology evaluation was at a median time of 1.8 months (0.5-8.0, range) and the second at 5.3 months (1.9-12.5, range).…”

Section: Sabr-related Predictors Of Response In Primary Tumor-specific Oligometastatic Disease Colorectal Cancermentioning

confidence: 99%

“… LC: -GTV (HR 8.5, p-value 0.003) LC: -SABR dose (HR, 0.12; p-value 0.010) Jingu, 17 2017 Retrospective 93/104 69 Lung 50 Gy/3–15 fr 105.6 28 65% (3yrs) 56% (5yrs) 56% (3yrs) 43% (5yrs) N.A. LC: -age > 70 (HR=0.416, p-value 0.044) LC: -Rectal primary tumor (HR=0.375, p-value 0.025) LC: -BED 10 ≥100 Gy (HR=0.100, p-value 0.027) -chemotherapy after SABR (HR=0.246, p-value 0.003) Joo, 18 2017 Retrospective 70/103 65 Liver 45–60/3–4 fr 60–180 34.2 93% (1y) 73% (2yrs) 68% (3yrs) 75% (2yrs) 35% (2yrs) LC: -age (HR 1.05; p-value 0.02) LC: -liver MRI (HR 3.35; p-value 0.03) OS: -Extrahepatic recurrence (HR 4.77; p-value < 0.01) LC: -BED 132–180 (HR 0.24; p-value 0.03) -chemotherapy lines > 3 (HR 3.34; p-value <0.01) Ottaiano, 29 2018 Retrospective 47/174 67 Liver lung Nodes 60 Gy/ 3 fr 180 48.8 N.A. 44 mos (median) 13 mos (median) N.A.…”

Section: Sabr-related Predictors Of Response In Primary Tumor-specific Oligometastatic Diseasementioning

confidence: 99%

“…The same result was reported in another retrospective analysis. 29 Franzese et al showed that non-lung metastases predicted poor OS in a large retrospective study. 27 The metachronous timing of metastases was a positive prognostic factor for OS and PFS in a Phase II trial.…”

Section: Sabr-related Predictors Of Response In Primary Tumor-specific Oligometastatic Diseasementioning

confidence: 99%

“… 22 A complete response after first-line of chemotherapy at radiologic evaluation improved PFS in a retrospective study. 29 The conflicting results on pre-SABR systemic therapy could be related to the retrospective nature of these studies and patients selection bias. Furthermore, Jingu et al showed in multivariate analysis that chemotherapy after SABR improved LC in pulmonary oligometastatic disease from CRC.…”

Section: Sabr-related Predictors Of Response In Primary Tumor-specific Oligometastatic Diseasementioning

confidence: 99%

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Knowing When to Use Stereotactic Ablative Radiation Therapy in Oligometastatic Cancer

Franceschini

Teriaca

Dominici

et al. 2021

CMAR

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Oligometastatic patients are a heterogeneous and yet not well-defined population. The actual definition identifies as oligometastatic, patients with 1-5 metastases in 1-3 different organs. However, only a proportion of these patients are "true" oligometastatic and therefore derive some kinds of benefit from local ablative approaches like stereotactic ablative radiation therapy (SABR). Since SABR is an easily accessible, effective and welltolerated treatment, it is widely employed in the oligometastatic scenarios, without a particular focus on selection criteria. However, it should be crucial to identify predictive and prognostic features that could be clinically implemented. Therefore, we conducted this narrative review of the available literature to summarize all clinical, radiomic, genetic and epigenetic features found to be predictive of overall survival, progression-free survival or local control of oligometastatic patients treated with SABR.

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Section: Sabr-related Predictors Of Response In Primary Tumor-specific Oligometastatic Disease Colorectal Cancermentioning

confidence: 90%

Section: Sabr-related Predictors Of Response In Primary Tumor-specific Oligometastatic Disease Colorectal Cancermentioning

confidence: 99%

Section: Sabr-related Predictors Of Response In Primary Tumor-specific Oligometastatic Diseasementioning

confidence: 99%

Section: Sabr-related Predictors Of Response In Primary Tumor-specific Oligometastatic Diseasementioning

confidence: 99%

Section: Sabr-related Predictors Of Response In Primary Tumor-specific Oligometastatic Diseasementioning

confidence: 99%

See 3 more Smart Citations

Knowing When to Use Stereotactic Ablative Radiation Therapy in Oligometastatic Cancer

Franceschini

Teriaca

Dominici

et al. 2021

CMAR

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A meta-analysis of stereotactic radiotherapy for pulmonary oligometastases from colorectal cancer

Liu¹,

Lei²

2019

WCJD

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Oligo-metastatic neoPlasms from the gastro-intestinal tract: iDentIfiCaTIon of cliNical and molecular drivers: the PREDICTION study

Ottaiano,

De Luca,

Santorsola

et al. 2023

BMC Cancer

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Background Metastatic disease in tumors originating from the gastrointestinal tract can exhibit varying degrees of tumor burden at presentation. Some patients follow a less aggressive disease course, characterized by a limited number of metastatic sites, referred to as “oligo-metastatic disease” (OMD). The precise biological characteristics that define the oligometastatic behavior remain uncertain. In this study, we present a protocol designed to prospectively identify OMD, with the aim of proposing novel therapeutic approaches and monitoring strategies. Methods The PREDICTION study is a monocentric, prospective, observational investigation. Enrolled patients will receive standard treatment, while translational activities will involve analysis of the tumor microenvironment and genomic profiling using immunohistochemistry and next-generation sequencing, respectively. The first primary objective (descriptive) is to determine the prevalence of biological characteristics in OMD derived from gastrointestinal tract neoplasms, including high genetic concordance between primary tumors and metastases, a significant infiltration of T lymphocytes, and the absence of clonal evolution favoring specific driver genes (KRAS and PIK3CA). The second co-primary objective (analytic) is to identify a prognostic score for true OMD, with a primary focus on metastatic colorectal cancer. The score will comprise genetic concordance (> 80%), high T-lymphocyte infiltration, and the absence of clonal evolution favoring driver genes. It is hypothesized that patients with true OMD (score 3+) will have a lower rate of progression/recurrence within one year (20%) compared to those with false OMD (80%). The endpoint of the co-primary objective is the rate of recurrence/progression at one year. Considering a reasonable probability (60%) of the three factors occurring simultaneously in true OMD (score 3+), using a significance level of α = 0.05 and a test power of 90%, the study requires a minimum enrollment of 32 patients. Discussion Few studies have explored the precise genetic and biological features of OMD thus far. In clinical settings, the diagnosis of OMD is typically made retrospectively, as some patients who undergo intensive treatment for oligometastases develop polymetastatic diseases within a year, while others do not experience disease progression (true OMD). In the coming years, the identification of true OMD will allow us to employ more personalized and comprehensive strategies in cancer treatment. Trial registration ClinicalTrials.gov ID NCT05806151.

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Integration of stereotactic radiotherapy in the treatment of metastatic colorectal cancer patients: a real practice study with long-term outcome and prognostic factors

Cited by 6 publications

References 35 publications

Knowing When to Use Stereotactic Ablative Radiation Therapy in Oligometastatic Cancer

Knowing When to Use Stereotactic Ablative Radiation Therapy in Oligometastatic Cancer

A meta-analysis of stereotactic radiotherapy for pulmonary oligometastases from colorectal cancer

Oligo-metastatic neoPlasms from the gastro-intestinal tract: iDentIfiCaTIon of cliNical and molecular drivers: the PREDICTION study

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