Relationships Between Köhne Category/Baseline Tumor Load and Early Tumor Shrinkage, Depth of Response, and Outcomes in Metastatic Colorectal Cancer

Sartore‐Bianchi, Andrea; García‐Alfonso, Pilar; Geißler, Michael; Köhne, Claus‐Henning; Peeters, Marc; Price, Timothy; Valladares‐Ayerbes, Manuel; Zhang, Ying; Burdon, Peter; Taı̈eb, Julien; Modest, Dominik Paul

doi:10.1016/j.clcc.2021.05.007

Cited by 2 publications

(2 citation statements)

References 34 publications

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“…Excellent response manifested as near total pCR, which is uncommon and very rare in mCRC treatment. The parameters such as ETS ≥20-30%, high DOR and pCR are linked with favourable prognosis in mCRC patients [16]. Sugery of liver metastases a contributing factor to better survival.…”

Section: Discussionmentioning

confidence: 99%

“…For patients whose tumours do not harbour mutations in RAS genes, RAS wild type (WT), anti-EGFR antibodies combined with chemotherapy induced better response rates and exhibited more frequent novel radiological parameters, such as early tumour shrinkage (ETS) and depth of response (DOR), compared to bevacizumab [14,15]. The importance of ETS and DOR is even beyond conversion and resection rates, while it is proved that it correlates with survival outcomes [16,17].…”

Section: Discussionmentioning

confidence: 99%

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Pathologic complete response in metastatic right-sided colon cancer treated with panitumumab and FOLFOX4 chemotherapy regimen

et al. 2022

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Introduction Recommended biological agents for the first line treatment of left-sided metastatic colorectal cancer (mCRC) without mutations in RAS/BRAF genes is cetuximab or panitumumab, while for right-sided mCRC bevacizumab is advised instead. For transversal colon mCRC the data about biological treatment efficacy is lacking. We present a patient with right-sided mCRC originated from transversal colon where panitumumab and chemotherapy treatment resulted in great outcome. Case outline A 56-year-old woman was diagnosed with transversal colon adenocarcinoma, without RAS genes mutations, with multiple liver metastases disseminated in both lobes. After the operation of primary tumour, the patient was treated with panitumumab and FOLFOX4 chemotherapy regimen. After 2 months of treatment, the dramatic response was evident, sum of diameter of target lesions decreased for 70.5%. After 2 more months of therapy, further decrease for 22.5% was evident. Liver metastases were operated on. Histopathology revealed fibrotic and necrotic tissue in all suspicious lesions, except in one focus where adenocarcinoma was found, but with 90% of surrounding necrosis. Twelve months after liver surgery the patient is without signs of progressive disease. Conclusion Detailed comprehensive studies of genetic features of mCRC hold a key to personalized treatment options and better outcomes for patients with mCRC.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Pathologic complete response in metastatic right-sided colon cancer treated with panitumumab and FOLFOX4 chemotherapy regimen

et al. 2022

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Utility of Assessing Early Tumor Shrinkage as an Efficacy Predictor in Patients with Non-Surgically Indicated or Recurrent Esophageal Cancer Treated with Nivolumab plus Ipilimumab

Natsuki,

Lee,

Kasashima

et al. 2024

Oncology

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Introduction: Nivolumab plus ipilimumab combination therapy has been administered as a first-line treatment in Japan since 2022 for patients with unresectable progressive or recurrent esophageal cancer. The efficacy and safety of this immune checkpoint inhibitor (ICI) doublet therapy is now being evaluated, and it is necessary to identify populations that benefit from this treatment at an early phase after initiation. For patients not showing early benefit, changing as soon as possible to other therapeutic strategies could improve their survival outcomes. Therefore, we attempted to identify decision-making factors such as early tumor shrinkage (ETS) based on treatment experience with ICI doublet therapy. Methods: The study included 19 patients who received nivolumab plus ipilimumab for non–surgically indicated or recurrent esophageal cancer between July 2022 and November 2023. Tumors were assessed approximately every 2 months after treatment initiation. The effects of ETS, depth of response (DpR), and clinicopathologic features, including immune-related adverse events (irAEs), on progression-free and overall survival were evaluated using Kaplan-Meyer plots and Cox proportional hazard models. Results: The mean duration of ICI doublet administration was 5.89 months (range, 1-16 months). At first evaluation, patients who exhibited no tumor progression >20% indicated possible response to ICI doublet therapy, and patients whose tumors shrank even minimally exhibited favorable progression-free survival. Higher DpR at any cut-off line exhibited better progression-free survival than those with lower DpR. Fifteen patients experienced irAEs, with 13 of these patients experiencing irAEs within 3 months of treatment initiation. irAEs were associated with the efficacy of ICI doublet therapy, but efficacy could not be predicted based on early irAE experience. Conclusion: ETS-high, DpR-high, and irAEs might be associated with favorable responses to nivolumab plus ipilimumab. As a predictor of efficacy at an early phase, ETS >0% could be a deciding factor for continuing ICI doublet therapy.

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Relationships Between Köhne Category/Baseline Tumor Load and Early Tumor Shrinkage, Depth of Response, and Outcomes in Metastatic Colorectal Cancer

Cited by 2 publications

References 34 publications

Pathologic complete response in metastatic right-sided colon cancer treated with panitumumab and FOLFOX4 chemotherapy regimen

Pathologic complete response in metastatic right-sided colon cancer treated with panitumumab and FOLFOX4 chemotherapy regimen

Utility of Assessing Early Tumor Shrinkage as an Efficacy Predictor in Patients with Non-Surgically Indicated or Recurrent Esophageal Cancer Treated with Nivolumab plus Ipilimumab

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