Cancer Research and Treatment

Original Articles

Genitourinary cancer

Neoadjuvant Cisplatin-Based Chemotherapy Followed by Selective Bladder Preservation Chemoradiotherapy in Muscle-Invasive Urothelial Carcinoma of the Bladder: Post Hoc Analysis of Two Prospective Studies: Sung Wook Cho, Sung Hee Lim, Ghee Young Kwon, Chan Kyo Kim, Won Park, Hongryull Pyo, Jae Hoon Chung, Wan Song, Hyun Hwan Sung, Byong Chang Jeong, Se Hoon Park; Cancer Res Treat. 2024;56(3):893-897. Published online February 15, 2024; DOI: https://doi.org/10.4143/crt.2024.015

Purpose
Bladder preservation chemoradiotherapy (CRT) in patients with a clinical complete response (cCR) following cisplatin-based neoadjuvant chemotherapy (NAC) is a promising treatment strategy for muscle-invasive bladder urothelial carcinoma (MIBC). A combined analysis of raw data from two prospective phase II studies was performed to better evaluate the feasibility of selective bladder preservation CRT.
Materials and Methods
The analysis was based on primary efficacy data from two independent studies, including 76 MIBC patients receiving NAC followed by bladder preservation CRT. The efficacy data included metastasis-free survival (MFS) and disease-free survival (DFS). For the present analysis, starting point of survival was defined as the date of commencing CRT.
Results
Among 76 patients, 66 had a cCR following NAC. Sixty-four patients received gemcitabine and cisplatin (GC) combination chemotherapy in neoadjuvant setting, and 12 received nivolumab plus GC. Bladder preservation CRT following NAC was generally well-tolerated, with low urinary tract symptoms being the most common late complication. With a median follow-up of 64 months, recurrence was recorded in 43 patients (57%): intravesical only (n=20), metastatic only (n=16), and both (n=7). In 27 patients with intravesical recurrence, transurethral resection, and Bacillus Calmette-Guerin treatment was given to 17 patients. Salvage cystectomy was performed in 10 patients. Median DFS was 46.3 (95% confidence interval [CI], 25.1 to 67.5) months, and the median MFS was not reached. Neither DFS nor MFS appeared to be affected by any of the baseline characteristics. However, DFS was significantly longer in patients with a cCR than in those without (hazard ratio, 0.465; 95% CI, 0.222 to 0.976).
Conclusion
The strategy of NAC followed by selective bladder preservation CRT based on the cCR is feasible in the treatment of MIBC. A standardized definition of cCR is needed to better assess disease status post-NAC.

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News and prospects on radiotherapy for bladder cancer: Is trimodal therapy becoming the gold standard?
Olivier Riou, Christophe Hennequin, Jonathan Khalifa, Paul Sargos
Cancer/Radiothérapie.2024; 28(6-7): 623. CrossRef

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Gastrointestinal cancer

Prediction of Pathologic Response to Neoadjuvant Chemoradiotherapy in Patients with Esophageal Squamous Cell Carcinoma Incorporating Hematological Biomarkers: Yingjia Wu, Jinbin Chen, Lei Zhao, Qiaoqiao Li, Jinhan Zhu, Hong Yang, Suping Guo, Mian Xi; Cancer Res Treat. 2021;53(1):172-183. Published online September 4, 2020; DOI: https://doi.org/10.4143/crt.2020.594

Abstract PDF Supplementary Material PubReader ePub

Purpose
This study aimed to develop a nomogram for predicting pathologic complete response (pCR) after neoadjuvant chemoradiotherapy (CRT) in patients with esophageal squamous cell carcinoma (ESCC) by integrating hematological biomarkers and clinicopathological characteristics.
Materials and Methods
Between 2003 and 2017, 306 ESCC patients who underwent neoadjuvant CRT followed by esophagectomy were analyzed. Besides clinicopathological factors, hematological parameters before, during, and after CRT were collected. Univariate and multivariate logistic regression analyses were performed to identify predictive factors for pCR. A nomogram model was built and internally validated.
Results
Absolute lymphocyte count (ALC), lymphocyte to monocyte ratio, albumin, hemoglobin, white blood cell, neutrophil, and platelet count generally declined, whereas neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) increased significantly following neoadjuvant CRT. After surgery, 124 patients (40.5%) achieved a pCR. The pCR group demonstrated significantly more favorable survival than the non-pCR group. On multivariate analysis, significant factors associated with pCR included sex, chemotherapy regimen, post-CRT endoscopic finding, pre-CRT NLR, ALC nadir during CRT, and post-CRT PLR, which were incorporated into the prediction model. The nomogram indicated good accuracy in predicting pCR, with a C-index of 0.75 (95% confidence interval, 0.71 to 0.78).
Conclusion
Female, chemotherapy regimen of cisplatin/vinorelbine, negative post-CRT endoscopic finding, pre-CRT NLR (≤ 2.1), ALC nadir during CRT (> 0.35 ×10⁹/L), and post-CRT PLR (≤ 83.0) were significantly associated with pCR in ESCC patients treated with neoadjuvant CRT. A nomogram incorporating hematological biomarkers to predict pCR was developed and internally validated, showing good predictive performance.

Citations

Citations to this article as recorded by

CT-based deep learning radiomics and hematological biomarkers in the assessment of pathological complete response to neoadjuvant chemoradiotherapy in patients with esophageal squamous cell carcinoma: A two-center study
Meng Zhang, Yukun Lu, Hongfu Sun, Chuanke Hou, Zichun Zhou, Xiao Liu, Qichao Zhou, Zhenjiang Li, Yong Yin
Translational Oncology.2024; 39: 101804. CrossRef
A machine learning approach using 18F-FDG PET and enhanced CT scan-based radiomics combined with clinical model to predict pathological complete response in ESCC patients after neoadjuvant chemoradiotherapy and anti-PD-1 inhibitors
Wei-Xiang Qi, Shuyan Li, Jifeng Xiao, Huan Li, Jiayi Chen, Shengguang Zhao
Frontiers in Immunology.2024;[Epub] CrossRef
Neoadjuvant PD-1 Plus Chemotherapy for Locally Advanced Esophageal Squamous Cell Carcinoma
Ting Qian, Delin Liu, Guochun Cao, Zhipeng Chen, Qin Zhang
Technology in Cancer Research & Treatment.2024;[Epub] CrossRef
Nomogram for predicting pathologic complete response to neoadjuvant chemoradiotherapy in patients with esophageal squamous cell carcinoma
Guihong Liu, Tao Chen, Xin Zhang, Binbin Hu, Jiayun Yu
Cancer Medicine.2024;[Epub] CrossRef
Pathological response to neoadjuvant chemoradiotherapy for oesophageal squamous cell carcinoma in Eastern versus Western countries: meta-analysis
Xing Gao, Hidde C G Overtoom, Ben M Eyck, Shi-Han Huang, Daan Nieboer, Pieter C van der Sluis, Sjoerd M Lagarde, Bas P L Wijnhoven, Yin-Kai Chao, Jan J B van Lanschot
British Journal of Surgery.2024;[Epub] CrossRef
Integrating MR radiomics and dynamic hematological factors predicts pathological response to neoadjuvant chemoradiotherapy in esophageal cancer
Yunsong Liu, Zeliang Ma, Yongxing Bao, Xin Wang, Yu Men, Xujie Sun, Feng Ye, Kuo Men, Jianjun Qin, Nan Bi, Liyan Xue, Zhouguang Hui
Heliyon.2024; 10(13): e33702. CrossRef
Preoperative neutrophil–to–lymphocyte ratio after chemoradiotherapy for esophageal squamous cell carcinoma associates with postoperative pulmonary complications following radical esophagectomy
Chien-Ming Lo, Hung-I. Lu, Yu-Ming Wang, Yen-Hao Chen, Yu Chen, Li-Chun Chen, Shau-Hsuan Li
Perioperative Medicine.2024;[Epub] CrossRef
Prognostic Impact of Inflammation-Based Factors in Patients with Esophageal Squamous Cell Carcinoma Achieving Pathological Complete Response After Neoadjuvant Chemoradiotherapy Followed by Surgery
Ji Yong Kim, Jae Kwang Yun, Yong-Hee Kim, Seung-il Park, Jeong Hoon Lee, Hwoon-Yong Jung, Gin Hyug Lee, Ho June Song, Do Hoon Kim, Kee Don Choi, Ji Yong Ahn, Sung-Bae Kim, Kyung-Ja Cho, Jin-Sook Ryu, Jong Hoon Kim, Jihoon Kang, Sook Ryun Park, Hyeong Ryul
Annals of Surgical Oncology.2024; 31(10): 6662. CrossRef
The relationship between systemic immune-inflammation indexes and treatment response in locally advanced esophageal cancer
Esra KEKİLLİ, Ebru ATASEVER AKKAŞ, Serab UYAR, Emre YEKEDÜZ
Anatolian Current Medical Journal.2023; 5(1): 53. CrossRef
A Novel Predictor of Pathologic Complete Response for Neoadjuvant Immunochemotherapy in Resectable Locally Advanced Esophageal Squamous Cell Carcinoma
Yalan Yang, Dao Xin, Huike Wang, Lulu Guan, Xiangrui Meng, Taiying Lu, Xiwen Bai, Feng Wang
Journal of Inflammation Research.2023; Volume 16: 1443. CrossRef
Gut microbiome can predict chemoradiotherapy efficacy in patients with esophageal squamous cell carcinoma
Takuma Sasaki, Yasunori Matsumoto, Kentaro Murakami, Satoshi Endo, Takeshi Toyozumi, Ryota Otsuka, Kazuya Kinoshita, Jie Hu, Shinichiro Iida, Hiroki Morishita, Yuri Nishioka, Akira Nakano, Masaya Uesato, Hisahiro Matsubara
Esophagus.2023; 20(4): 691. CrossRef
Pretreatment absolute lymphocyte count is an independent predictor for survival outcomes for esophageal squamous cell carcinoma patients treated with neoadjuvant chemoradiotherapy and pembrolizumab: An analysis from a prospective cohort
Wei‐Xiang Qi, Xiaoyan Wang, Chengqiang Li, Shuyan Li, Huan Li, Feifei Xu, Jiayi Chen, Shengguang Zhao, Hecheng Li
Thoracic Cancer.2023; 14(17): 1556. CrossRef
Prognostic analysis and treatment utilization of different treatment strategies in elderly esophageal cancer patients with distant metastases: a SEER database analysis
Lian-Qiang Han, Ting-Ting Cui, Nian-Jun Xiao, Wen Li
Journal of Cancer Research and Clinical Oncology.2023; 149(17): 15413. CrossRef
Effect of dynamic platelet-to-lymphocyte ratio on the prognosis of patients with esophageal squamous cell carcinoma receiving chemoradiotherapy
Dan He, Shulan Du, Songyuan He, Hao Song, Bo Pu, Guojun Zhang, Chuan Yang
Medicine.2023; 102(49): e36554. CrossRef
Nomogram for predicting pathologic complete response following preoperative chemoradiotherapy in patients with esophageal squamous cell carcinoma
Young Seob Shin, Jeong Yun Jang, Ye Jin Yoo, Jesang Yu, Kye Jin Song, Yoon Young Jo, Sung-Bae Kim, Sook Ryun Park, Ho June Song, Yong-Hee Kim, Hyeong Ryul Kim, Jong Hoon Kim
Gastroenterology Report.2023;[Epub] CrossRef
Impact of Platelets to Lymphocytes Ratio and Lymphocytes during Radical Concurrent Radiotherapy and Chemotherapy on Patients with Nonmetastatic Esophageal Squamous Cell Carcinoma
Yaotian Zhang, Ning Han, Xue Zeng, Chaonan Sun, Shichen Sun, Xinchi Ma, Yanyu Zhang, Zhuang Liu, Zilan Qin, Hong Guo, Yubing Li, Na Zhang, Bruno Vincenzi
Journal of Oncology.2022; 2022: 1. CrossRef
Serum Anti-BRAT1 is a Common Molecular Biomarker for Gastrointestinal Cancers and Atherosclerosis
Liubing Hu, Jiyue Liu, Hideaki Shimada, Masaaki Ito, Kazuo Sugimoto, Takaki Hiwasa, Qinghua Zhou, Jianshuang Li, Si Shen, Hao Wang
Frontiers in Oncology.2022;[Epub] CrossRef
Impact of radiotherapy on the immune landscape in oesophageal adenocarcinoma
Noel E Donlon, Maria Davern, Fiona O’Connell, Andrew Sheppard, Aisling Heeran, Anshul Bhardwaj, Christine Butler, Ravi Narayanasamy, Claire Donohoe, James J Phelan, Niamh Lynam-Lennon, Margaret R Dunne, Stephen Maher, Jacintha O’Sullivan, John V Reynolds,
World Journal of Gastroenterology.2022; 28(21): 2302. CrossRef
Pathologic Complete Response Prediction to Neoadjuvant Immunotherapy Combined with Chemotherapy in Resectable Locally Advanced Esophageal Squamous Cell Carcinoma: Real-World Evidence from Integrative Inflammatory and Nutritional Scores
Jifeng Feng, Liang Wang, Xun Yang, Qixun Chen, Xiangdong Cheng
Journal of Inflammation Research.2022; Volume 15: 3783. CrossRef
The Role of Neutrophil-to-Lymphocyte Ratio in Predicting Pathological Response for Resectable Non–Small Cell Lung Cancer Treated with Neoadjuvant Chemotherapy Combined with PD-1 Checkpoint Inhibitors
Xiaoyan Sun, Yingnan Feng, Bin Zhang, Wuhao Huang, Xiaoliang Zhao, Hua Zhang, Dongsheng Yue, Changli Wang
Cancer Research and Treatment.2022; 54(4): 1017. CrossRef
The predictive value of peripheral blood cells and lymphocyte subsets in oesophageal squamous cell cancer patients with neoadjuvant chemoradiotherapy
Jin Zhou, Hai-Ping Lin, Xin Xu, Xiao-Hang Wang, Ling Rong, Yao Zhang, Lei Shen, Lei Xu, Wei-Ting Qin, Qing Ye, Xiu-Mei Ma, Yong-Rui Bai
Frontiers in Immunology.2022;[Epub] CrossRef

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Impact of Mucin Proportion in the Pretreatment MRI on the Outcomes of Rectal Cancer Patients Undergoing Neoadjuvant Chemoradiotherapy: Eunji Kim, Kyubo Kim, Se Hyung Kim, Sae-Won Han, Tae-You Kim, Seung-Yong Jeong, Kyu Joo Park, Jaemoon Koh, Gyeong Hoon Kang, Eui Kyu Chie; Cancer Res Treat. 2019;51(3):1188-1197. Published online December 20, 2018; DOI: https://doi.org/10.4143/crt.2018.434

Abstract PDF PubReader ePub

Purpose
The purpose of this study was to evaluate treatment response to neoadjuvant chemoradiotherapy (CRT) with regard to mucin status in pathology and pretreatment magnetic resonance imaging (MRI) in locally advanced rectal cancer.
Materials and Methods
Between 2003 and 2011, 306 patients with locally advanced rectal cancer received neoadjuvant CRT followed by surgery, and mucinous adenocarcinoma (MAC) was found in 27 (8.8%). All MAC patients had MRI before and after CRT and mucin proportion at MRI was measured. Therapeutic response was assessed by pathology after total mesorectal excision. To determine the optimal cut-off for mucin proportion in predicting good CRT response (near total or total regression) and negative circumferential resection margin (CRM), the receiver-operating characteristic analysis was performed.
Results
After neoadjuvant CRT, overall downstaging occurred in 44.4% of MAC and 72.4% of non-MAC (p=0.001), and positive CRM (≤1 mm) was observed more frequently in MAC (p<0.001). The optimal threshold for treatment response was 30% for mucin proportion, and there are nine with low mucin proportion (<30%) and 18 with high mucin proportion (≥30%) in pretreatment MRI. Negative CRM and tumor downstaging occurred more common in patients with mucin <30%, although statistically insignificant (p=0.071 and p=0.072, respectively). Regarding oncologic outcomes, lower mucin proportion in pretreatment MRI was associated with better disease-free and overall survival in MAC group (p=0.092 and 0.056, respectively), but the difference did not reach statistical significance.
Conclusion
Poor treatment outcome with neoadjuvant CRT was observed in patients with MAC, especially those with high mucin proportion at pretreatment MRI.

Citations

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Mucinous histology is a negative predictor of neoadjuvant chemoradiotherapy for locally advanced rectal adenocarcinoma
Xiangwen Tan, Yiwei Zhang, Xiaofeng Wu, Qing Fang, Yunhua Xu, Shuxiang Li, Jinyi Yuan, Xiuda Peng, Kai Fu, Shuai Xiao
BMC Gastroenterology.2024;[Epub] CrossRef
Incomplete Resection Is Twice as Likely in Locally Advanced Mucinous Compared to Nonmucinous Rectal Adenocarcinoma: A National Propensity‐Matched Analysis
Leah E. Hendrick, Samer Naffouje, Iman Imanirad, Allan Lima Pereira, Tiago Biachi, Julian Sanchez, Sophie Dessureault, Amalia Stefanou, Sean P. Dineen, Seth Felder
Journal of Surgical Oncology.2024;[Epub] CrossRef
Accelerated T2W Imaging with Deep Learning Reconstruction in Staging Rectal Cancer: A Preliminary Study
Lan Zhu, Bowen Shi, Bei Ding, Yihan Xia, Kangning Wang, Weiming Feng, Jiankun Dai, Tianyong Xu, Baisong Wang, Fei Yuan, Hailin Shen, Haipeng Dong, Huan Zhang
Journal of Imaging Informatics in Medicine.2024;[Epub] CrossRef
Mucinous rectal cancers: clinical features and prognosis in a population-based cohort
Malin Enblad, Klara Hammarström, Joakim Folkesson, Israa Imam, Milan Golubovik, Bengt Glimelius
BJS Open.2022;[Epub] CrossRef
Mucin-Containing Rectal Cancer: A Review of Unique Imaging, Pathology, and Therapeutic Response Features
David D. Childs, Caio Max Sao Pedro Rocha Lima, Yi Zhou
Seminars in Roentgenology.2021; 56(2): 186. CrossRef
Advances in radiological staging of colorectal cancer
R.J. Goiffon, A. O'Shea, M.G. Harisinghani
Clinical Radiology.2021; 76(12): 879. CrossRef
A Comprehensive Evaluation of Associations Between Routinely Collected Staging Information and The Response to (Chemo)Radiotherapy in Rectal Cancer
Klara Hammarström, Israa Imam, Artur Mezheyeuski, Joakim Ekström, Tobias Sjöblom, Bengt Glimelius
Cancers.2020; 13(1): 16. CrossRef

8,583 View
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