Evidence map›Paper›PMID 33895946›Full record

ArticleOncology and therapy2021

Recommendations for Specimen and Therapy Selection in Colorectal Cancer.

Snehal B Patel, Robert Bookstein, Navid Farahani, Myriam Chevarie-Davis, Andy Pao, Angela Aguiluz, Christian Riley, Jennelle C Hodge, Serhan Alkan, Zhenqui Liu and 2 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Oncology and therapy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Snehal B PatelCedars-Sinai Medical Center, Division of Molecular Pathology and Cytogenetics, Department of Pathology and Laboratory Medicine, 8700 Beverly Blvd., SSB #362, Los Angeles, CA, 90048, USA.
Robert BooksteinCedars-Sinai Medical Center, Division of Molecular Pathology and Cytogenetics, Department of Pathology and Laboratory Medicine, 8700 Beverly Blvd., SSB #362, Los Angeles, CA, 90048, USA.
Navid FarahaniCedars-Sinai Medical Center, Division of Molecular Pathology and Cytogenetics, Department of Pathology and Laboratory Medicine, 8700 Beverly Blvd., SSB #362, Los Angeles, CA, 90048, USA.
Myriam Chevarie-DavisCedars-Sinai Medical Center, Division of Molecular Pathology and Cytogenetics, Department of Pathology and Laboratory Medicine, 8700 Beverly Blvd., SSB #362, Los Angeles, CA, 90048, USA.
Andy PaoCedars-Sinai Medical Center, Division of Molecular Pathology and Cytogenetics, Department of Pathology and Laboratory Medicine, 8700 Beverly Blvd., SSB #362, Los Angeles, CA, 90048, USA.
Angela AguiluzCedars-Sinai Medical Center, Division of Molecular Pathology and Cytogenetics, Department of Pathology and Laboratory Medicine, 8700 Beverly Blvd., SSB #362, Los Angeles, CA, 90048, USA.
Christian RileyCedars-Sinai Medical Center, Division of Molecular Pathology and Cytogenetics, Department of Pathology and Laboratory Medicine, 8700 Beverly Blvd., SSB #362, Los Angeles, CA, 90048, USA.
Jennelle C HodgeCedars-Sinai Medical Center, Division of Molecular Pathology and Cytogenetics, Department of Pathology and Laboratory Medicine, 8700 Beverly Blvd., SSB #362, Los Angeles, CA, 90048, USA.
Serhan AlkanCedars-Sinai Medical Center, Division of Molecular Pathology and Cytogenetics, Department of Pathology and Laboratory Medicine, 8700 Beverly Blvd., SSB #362, Los Angeles, CA, 90048, USA.
Zhenqui LiuCedars-Sinai Medical Center, Biostatistics and Bioinformatics Research Center, Samuel Oschin Comprehensive Cancer Institute, Los Angeles, CA, USA.
Nan DengCedars-Sinai Medical Center, Biostatistics and Bioinformatics Research Center, Samuel Oschin Comprehensive Cancer Institute, Los Angeles, CA, USA.
Jean R LopateguiCedars-Sinai Medical Center, Division of Molecular Pathology and Cytogenetics, Department of Pathology and Laboratory Medicine, 8700 Beverly Blvd., SSB #362, Los Angeles, CA, 90048, USA. Jean.Lopategui@cshs.org.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionNext-generation sequencing has emerged as a clinical tool for the identification of actionable mutations to triage advanced colorectal cancer patients for targeted therapies. The literature is conflicted as to whether primaries or their metastases should be selected for sequencing. Some authors suggest that either site may be sequenced, whereas others recommend sequencing the primary, the metastasis, or even both tumors. Here, we address this issue head on with a meta-analysis and provide for the first time a set of sensible recommendations to make this determination.

methodsFrom our own series, we include 43 tumors from 13 patients including 14 primaries, 10 regional lymph node metastases, 17 distant metastases, and two anastomotic recurrences sequenced using the 50 gene Ion AmpliSeq cancer NGS panel v2.

resultsBased on our new cohort and a meta-analysis, we found that ~ 77% of patient-matched primary-metastatic pairs have identical alterations in these 50 cancer-associated genes.

conclusionsLow tumor cellularity, tumor heterogeneity, clonal evolution, treatment status, sample quality, and/or size of the sequencing panel accounted for a proportion of the differential detection of mutations at primary and metastatic sites. The therapeutic implications of the most frequently discordant alterations (TP53, APC, PIK3CA, and SMAD4) are discussed. Our meta-analysis indicates that a subset of patients who fail initial therapy may benefit from sequencing of additional sites to identify new actionable genomic abnormalities not present in the initial analysis. Evidence-based recommendations are proposed.

Indexed as

Colorectal cancerNext-generation sequencingPaired primary and metastatic tumorsPatient-matched tumorsSpecimen selectionTherapy selectionTumor heterogeneity

Identifiers

PMID33895946
PMCPMC8593092

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.