Article Dans Une Revue European Journal of Cancer Année : 2024

Imaging-guided prognostic score-based approach to assess the benefits of combotherapy versus monotherapy with immune checkpoint inhibitors in metastatic MSI-H colorectal cancer patients

Rémy Barbe
  • Fonction : Auteur
Yves Menu
  • Fonction : Auteur
Romain Cohen
  • Fonction : Auteur
Clemence David
  • Fonction : Auteur
Michele Kind
  • Fonction : Auteur
Sana Harguem
  • Fonction : Auteur
Lama Dawi
  • Fonction : Auteur
Joya Hadchiti
  • Fonction : Auteur
Fatine Selhane
  • Fonction : Auteur
Nicolas Billet
  • Fonction : Auteur
Samy Ammari
  • Fonction : Auteur
Ambroise Bertin
  • Fonction : Auteur
Littisha Lawrance
  • Fonction : Auteur
Baptiste Cervantes
  • Fonction : Auteur
Antoine Hollebecque
  • Fonction : Auteur
Corinne Balleyguier
  • Fonction : Auteur
Paul-Henry Cournede
  • Fonction : Auteur
Hugues Talbot
Nathalie Lassau
  • Fonction : Auteur
Thierry Andre

Résumé

Background This retrospective study determined survival responses to immune checkpoint inhibitors (ICIs), comparing mono- (mono) and combo-immunotherapy (combo) in patients with microsatellite instability-high (MSI-H) metastatic colorectal cancer (mCRC) by analyzing quantitative imaging data and clinical factors. Methods One hundred fifty patients were included from two centers and divided into training (n = 105) and validation (n = 45) cohorts. Radiologists manually annotated chest-abdomen-pelvis computed tomography and calculated tumor burden. Progression-free survival (PFS) was assessed, and variables were selected through Recursive Feature Elimination. Cutoff values were determined using maximally selected rank statistics to binarize features, forming a risk score with hazard ratio-derived weights. Results In total, 2258 lesions were annotated with excellent reproducibility. Key variables in the training cohort included: total tumor volume (cutoff: 73 cm3), lesion count (cutoff: 20), age (cutoff: 60) and the presence of peritoneal carcinomatosis. Their respective weights were 1.13, 0.96, 0.91, and 0.38, resulting in a risk score cutoff of 1.36. Low-score patients showed similar overall survival and PFS regardless of treatment, while those with a high-score had significantly worse survivals with mono vs combo (P = 0.004 and P = 0.0001). In the validation set, low-score patients exhibited no significant difference in overall survival and PFS with mono or combo. However, patients with a high-score had worse PFS with mono (P = 0.046). Conclusions A score based on total tumor volume, lesion count, the presence of peritoneal carcinomatosis, and age can guide MSI-H mCRC treatment decisions, allowing oncologists to identify suitable candidates for mono and combo ICI therapies.

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Dates et versions

hal-04907203 , version 1 (22-01-2025)

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Citer

Rémy Barbe, Younes Belkouchi, Yves Menu, Romain Cohen, Clemence David, et al.. Imaging-guided prognostic score-based approach to assess the benefits of combotherapy versus monotherapy with immune checkpoint inhibitors in metastatic MSI-H colorectal cancer patients. European Journal of Cancer, 2024, 202, pp.114020. ⟨10.1016/j.ejca.2024.114020⟩. ⟨hal-04907203⟩
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