scholarly journals Oxaliplatin-containing adjuvant chemotherapy improves the survival of locally advanced rectal cancer patients with pathological complete response after pre-operative chemoradiotherapy

2018 ◽  
Vol 6 (3) ◽  
pp. 195-201 ◽  
Author(s):  
Jian-Hong Peng ◽  
Jun-Zhong Lin ◽  
Yu-Ming Rong ◽  
Ying Zhu ◽  
Yu-Xiang Deng ◽  
...  
2021 ◽  
Author(s):  
Shu-Biao Ye ◽  
Dong-Wen Chen ◽  
Pei-Si Li ◽  
Zhen-Sen Lin ◽  
Jia-Hui Long ◽  
...  

Abstract Background: Pathological complete response (pCR) and postoperative carcinoembryonic antigen (CEA) respectively represent pathological and biological response to treatment and prognostic indictors for locally advanced rectal cancer. However, the prognostic significance of integrated pCR and postoperative CEA model is rarely investigated. Methods: This big-data intelligence platform-based cohort biomarker study extracted clinicopathological characteristics and postoperative CEA of 919 locally advanced (clinical stage II-III) rectal cancer patients receiving neoadjuvant treatment from 6125 cases between April 2011 through September 2018 at Sun Yat-sen University, the Sixth Affiliated Hospital. An integrated model was constructed using pCR combined with the cut-off value of postoperative CEA generated from the receiver operating characteristic (ROC) curve. The model stratified locally advanced rectal cancer patients into four groups. Results: Both pathological response-pCR and biological response-postoperative CEA were independent prognostic indicators. In all patients, the 3-year distant metastasis-free survival (DMFS) (70.0%) and disease-free survival (DFS) (64.8%) rates were significantly lower in patients without pCR and postoperative CEA > 2.78 ng/ml (all p values < 0.05). Among patients treated with < 3 months of postoperative adjuvant chemotherapy (ACT), all others had higher 3-year DMFS and DFS rates. Among patients receiving ≥ 3 months of ACT, those without pCR had similar 3-year DMFS rates regardless of postoperative CEA level. Conclusions: The response integrated model with pCR and postoperative CEA not just effectively predict DMFS and DFS in locally advanced rectal cancer patients, but also was a predictive tool to potentially modify the optimal duration of ACT for locally advanced rectal cancer patients.


Author(s):  
Chiara Dalle Fratte ◽  
Silvia Mezzalira ◽  
Jerry Polesel ◽  
Elena De Mattia ◽  
Antonio Palumbo ◽  
...  

Pathological complete response after neoadjuvant chemoradiotherapy in locally advanced rectal cancer patients is related to a favorable prognosis. The identification of early biomarkers predictive of pathological complete response would help to optimize the multimodality management of the patients. A panel of 11 tumor-related proteins was investigated by immunohistochemistry in the pre-treatment biopsy of a group of locally advanced rectal cancer patients, to identify early biomarkers of pathological complete response to neoadjuvant chemoradiotherapy. A mono-institutional retrospective cohort of 95 stage II/III locally advanced rectal cancer patients treated with neoadjuvant chemoradiotherapy and surgery was selected based on clinical-pathological characteristics and the availability of a pre-treatment tumor biopsy. Eleven selected protein markers expression (MLH1, GLUT1, Ki67, CA-IX, CXCR4, COX2, CXCL12, HIF1, VEGF, CD44, and RAD51) was investigated. The optimal cut-off values were calculated by receiver operating characteristic curve analysis. Classification and regression tree analysis was performed to investigate the biomarkers interaction. Patients presenting either Ki67, HIF1 or RAD51 below the cut-off value, or CXCR4 or COX2 above the cut-off value, were more likely to get a pathological complete response. Classification and regression tree analysis identified three groups of patients resulting from the combination of Ki67 and CXCR4 expression. Patients with high expression of Ki67 had the lowest chance to get a pathological complete response (18%), as compared to patients with low expression of both Ki67 and CXCR4 (29%), and patients with low Ki67 and high CXCR4 expression (70%). Pre-treatment Ki67, CXCR4, COX2, HIF1, RAD51 in tumor biopsies are associated with pathological complete response after neoadjuvant chemoradiotherapy in locally advanced rectal cancer. A combined evaluation of Ki67 and CXCR4 would increase their predictive potential. If validated, their optimal cut-off could be used to select patients for a tailored multi-modality treatment.


2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e14696-e14696
Author(s):  
Seyda Gunduz ◽  
Hasan Senol Coskun ◽  
Sema Sezgin Goksu ◽  
Deniz Arslan ◽  
Ali Murat Tatli ◽  
...  

e14696 Background: The aim of this study was to determine the pathological complete response rates in a group of locally advanced rectal cancer patients who underwent chemoradiotherapy after treatment with induction FOLFOX chemotherapy and the relationship between the complete response and Positron emission tomography - computed tomography (PET-CT). Methods: The files of 239 patients who were diagnosed with rectal cancer between January 2008 and January 2012 were evaluated retrospectively. Of these, there were 24 locally advanced rectal cancer patients who met the following criteria: they were administered chemoradiotherapy after receiving four courses induction oxaliplatin, folinic acid and 5-Florouracil (FOLFOX) and they underwent PET-CT for staging and for the evaluation of their response to FOLFOX treatment. Of these 24 patients, 20 operable patients were included in the study. Results: The pathological complete response was obtained in 7 patients (35%) who were operated on, and then given induction four courses FOLFOX chemotherapy and chemoradiotherapy. We determined that age, gender, clinical stage at diagnosis, and PET-CT before and after induction chemotherapy were not predictive of the pathological complete response to tumor fluorodeoxyglucose (FDG) uptake activity. Conclusions: The rates of pathological complete response were increased in locally advanced rectal cancer patients who underwent short-term induction chemotherapy. Although the PET-CT has retained its importance in predicting pathological complete response, there is still a need for studies with a larger number of patients and long-term follow-ups.


2018 ◽  
Vol 29 ◽  
pp. v85
Author(s):  
X. Hernández-Yagüe ◽  
E. Canals-Subirats ◽  
G. Mateu Esquerda ◽  
C. Auñón Sanz ◽  
A. Maroto Genover ◽  
...  

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