ArticleJournal of clinical oncology : official journal of the American Society of Clinical Oncology2025
Characteristics of Patients and Prognostic Factors Across Treatment Lines in Metastatic Colorectal Cancer: An Analysis From the Aide et Recherche en Cancérologie Digestive Database.
Article in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Upfront Modified FOLFOXIRI Plus Panitumumab forJournal of clinical oncology : official journal of the American Society of Clinical Oncology · 2026Trial
- External Validation of the ARCAD Nomogram in a Real-World Cohort with Stage 4 Colorectal Cancer.Cancers · 2026Article
- First-line treatment efficacy and prognostic model in RAS-mutant metastatic colorectal cancer: a real-world study.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026Article
- Prognostic Impact of Cetuximab-Related Hypomagnesemia and Hypokalemia in RAS/RAF Wild-Type Colorectal Cancer: A Multicenter Study.Cancer management and research · 2026Article
- Development and validation of an AI-augmented deep learning model for survival prediction in de novo metastatic colorectal cancer.Discover oncology · 2025Article
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Authors and funding
21 authors.
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Abstract
purposeSeveral lines of treatment can be used sequentially in patients with metastatic colorectal cancer. We investigated the evolution of patient/tumor characteristics and their prognostic impact across treatment lines to develop an overall prognostic score (OPS). PATIENTS AND
methodsIndividual patient data from 48 randomized trials were analyzed. The end point was overall survival (from random assignment to death). Missing data were imputed. The complete data set was then separated into construction (80%) and validation sets (20%). The Cox's model was used to define risk groups for survival using the OPS. The discrimination capability was assessed in each treatment-line via bootstrapping to obtain optimism-corrected calibration and discrimination C-indices. Internal validation was done in the validation set.
resultsA total of 37,560 patients (26,974 in first-line [1L], 7,693 in second-line [2L], and 2,893 in third-line [3L]) were analyzed. Some clinical, biological, and molecular characteristics of patients/tumors included in therapeutic trials evolve over the lines. Seven independent prognostic variables were retained in the final multivariate model common to all lines: Eastern Cooperative Oncology Group performance status, hemoglobin, platelet count, WBC/absolute neutrophil count ratio, lactate dehydrogenase, alkaline phosphatase, and the number of metastatic sites. The OPS was used to define four patient subgroups with significantly different prognoses in 1L, 2L, and 3L, separately, with adequate C-indices: 0.65, 0.66, and 0.69 in the construction set and 0.65, 0.66, and 0.68 in the validation set, respectively. The OPS was not predictive, with 3L drugs (
conclusionThe same prognostic model using practical variables can be used before all treatment lines. The OPS could better stratify patients in future clinical trials and help to therapeutic decision in routine practice.
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