Evidence map›Paper›PMID 39011625›Full record

Trial reportThe oncologist2024

A novel risk classification model integrating CEA, ctDNA, and pTN stage for stage 3 colon cancer: a post hoc analysis of the IDEA-France trial.

Thomas Samaille, Antoine Falcoz, Romain Cohen, Pierre Laurent-Puig, Thierry André, Julien Taieb, Edouard Auclin, Dewi Vernerey

Abstract readClinical Trial, Phase III
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The oncologist, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–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

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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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

8 authors.

Thomas SamailleDepartment of Medical Oncology, Saint-Antoine Hospital, Sorbonne Université, Paris, France.ORCID 0009-0006-4502-0058
Antoine FalcozMethodology and Quality of Life Unit in Oncology, University Hospital of Besançon, Besançon, France.
Romain CohenDepartment of Medical Oncology, Saint-Antoine Hospital, Sorbonne Université, Paris, France.ORCID 0000-0001-9602-5162
Pierre Laurent-PuigInstitut du cancer Paris CARPEM, Georges Pompidou European Hospital, AP-HP, Université Paris Cité, Paris, France.
Thierry AndréDepartment of Medical Oncology, Saint-Antoine Hospital, Sorbonne Université, Paris, France.
Julien TaiebDepartment of Gastroenterology and GI oncology, Georges Pompidou European Hospital, SIRIC CARPE, Université Paris-Cité, Paris, France.ORCID 0000-0002-9955-4753
Edouard AuclinDepartment of Medical Oncology, Georges Pompidou European Hospital, AP-HP, Université Paris Cité, Paris, France.
Dewi VernereyMethodology and Quality of Life Unit in Oncology, University Hospital of Besançon, Besançon, France.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWe assessed the added value of incorporating carcinoembryonic antigen (CEA) to circulating tumor DNA (ctDNA) and pathological TN (pTN) stage for risk classification in stage 3 colon cancer (CC). PATIENTS AND

methodsWe retrospectively analyzed postoperative CEA values in patients with CC from the IDEA-France phase 3 trial. The relation between disease-free survival (DFS) and CEA was modeled through restricted cubic splines. Prognostic value of CEA, ctDNA, and pTN was assessed with the Kaplan-Meier method. Multivariate analysis was used to identify prognostic and predictive factors for DFS.

resultsAmong 696 patients (35%), CEA values were retrievable, and for 405 (20%) both CEA and ctDNA were available. An optimized CEA threshold of 2 ng/mL was identified, the 3-year DFS was 66.4% for patients above the threshold and 80.9% for those below (HR, 1.74; 95% CI, 1.33-2.28, P < .001). In multivariate analysis, CEA ≥ 2 ng/mL contributed significantly to model variability, becoming an independent prognostic factor for DFS (HR, 1.82; 95% CI,1.27-2.59), alongside ctDNA (HR, 1.88; 95% CI, 1.16-3.03) and pTN (HR, 1.78; 95% CI, 1.24-2.54). A novel integrated risk classification combining CEA, ctDNA, and pTN stage reclassified 19.8% of pT4/N2 patients as low risk and 2.5% of pT3/N1 patients as high risk. This new classification demonstrated the 3-year DFS of 80.8% for low-risk patients and 55.4% for high-risk patients (HR, 2.66, 95% CI, 1.84-3.86, P < .001).

conclusionsPostoperative CEA value is a prognostic factor for DFS in stage 3 CC, independently of ctDNA and pTN. It advocates for systematic reporting in future adjuvant trials. Integrating both biomarkers with pTN could refine risk classification in stage 3 CC.

Indexed as

Carcinoembryonic AntigenCirculating Tumor DNAColonic NeoplasmsNeoplasm StagingAdultAgedBiomarkers, TumorDisease-Free SurvivalFemaleHumansMaleMiddle AgedPrognosisRetrospective StudiesRisk AssessmentBiomarkers, TumorCarcinoembryonic AntigenCirculating Tumor DNAcarcinoembryonic antigencolon cancerctDNATN staging

Identifiers

PMID39011625
PMCPMC11546770

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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.