Selection of appropriate end-points (pCR vs 2yDFS) for tailoring treatments with prediction models in locally advanced rectal cancer
Valentini V, Van Stiphout RGPM, Lammering G, Gambacorta MA, Barba MC, Bebenek M, Bonnetain F, Bosset JF, Bujko K, Cionini L, Gerard JP, Rödel C, Sainato A, Sauer R, Minsky BD, Collette L, Lambin P (2015)
Publication Type: Journal article
Publication year: 2015
Journal
Publisher: Elsevier
Book Volume: 114
Pages Range: 302-9
Journal Issue: 3
DOI: 10.1016/j.radonc.2015.02.001
Abstract
Personalized treatments based on predictions for patient outcome require early characterization of a rectal cancer patient's sensitivity to treatment. This study has two aims: (1) identify the main patterns of recurrence and response to the treatments (2) evaluate pathologic complete response (pCR) and two-year disease-free survival (2yDFS) for overall survival (OS) and their potential to be relevant intermediate endpoints to predict.Pooled and treatment subgroup analyses were performed on five large European rectal cancer trials (2795 patients), who all received long-course radiotherapy with or without concomitant and/or adjuvant chemotherapy. The ratio of distant metastasis (DM) and local recurrence (LR) rates was used to identify patient characteristics that increase the risk of recurrences.The DM/LR ratio decreased to a plateau in the first 2 years, revealing it to be a critical follow-up period. According to the patterns of recurrences, three patient groups were identified: 5-15% had pCR and were disease free after 2 years (excellent prognosis), 65-75% had no pCR but were disease free (good prognosis) and 15-30% had neither pCR nor 2yDFS (poor prognosis).Compared with pCR, 2yDFS is a stronger predictor of OS. To adapt treatment most efficiently, accurate prediction models should be developed for pCR to select patients for organ preservation and for 2yDFS to select patients for more intensified treatment strategies.
Involved external institutions
European Organisation for Research and Treatment of Cancer (EORTC)
Belgium (BE)
Maastricht University
Netherlands (NL)
Catholic University of the Sacred Heart / Università Cattolica del Sacro Cuore
Italy (IT)
Lower Silesia Oncology Centre / Dolnośląskie Centrum Onkologii we Wrocławiu
Poland (PL)
Université Bourgogne Franche-Comté
France (FR)
Centre hospitalier régional et universitaire de Besançon (CHRU Besancon)
France (FR)
Maria Skłodowska-Curie Institute of Oncology / Centrum Onkologii–Instytut im. Marii Skłodowskiej-Curie w Warszawie
Poland (PL)
Azienda Ospedaliero-Universitaria Pisana
Italy (IT)
Centre Antoine Lacassagne (UNICANCER)
France (FR)
Goethe-Universität Frankfurt am Main
Germany (DE)
University of Texas MD Anderson Cancer Center
United States (USA) (US)
Belgium (BE)
Maastricht University
Netherlands (NL)
Catholic University of the Sacred Heart / Università Cattolica del Sacro Cuore
Italy (IT)
Lower Silesia Oncology Centre / Dolnośląskie Centrum Onkologii we Wrocławiu
Poland (PL)
Université Bourgogne Franche-Comté
France (FR)
Centre hospitalier régional et universitaire de Besançon (CHRU Besancon)
France (FR)
Maria Skłodowska-Curie Institute of Oncology / Centrum Onkologii–Instytut im. Marii Skłodowskiej-Curie w Warszawie
Poland (PL)
Azienda Ospedaliero-Universitaria Pisana
Italy (IT)
Centre Antoine Lacassagne (UNICANCER)
France (FR)
Goethe-Universität Frankfurt am Main
Germany (DE)
University of Texas MD Anderson Cancer Center
United States (USA) (US)
How to cite
APA:
Valentini, V., Van Stiphout, R.G.P.M., Lammering, G., Gambacorta, M.A., Barba, M.C., Bebenek, M.,... Lambin, P. (2015). Selection of appropriate end-points (pCR vs 2yDFS) for tailoring treatments with prediction models in locally advanced rectal cancer. Radiotherapy and Oncology, 114(3), 302-9. https://doi.org/10.1016/j.radonc.2015.02.001
MLA:
Valentini, Vincenzo, et al. "Selection of appropriate end-points (pCR vs 2yDFS) for tailoring treatments with prediction models in locally advanced rectal cancer." Radiotherapy and Oncology 114.3 (2015): 302-9.
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