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Predictive Factors for Chemotherapy Response in Colorectal Liver Metastasis: A Retrospective Study Utilizing
Li-Jun Wang1, Quan Bao1, Hong-Wei Wang1
1Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Hepato-Pancreato-Biliary Surgery Unit I, Peking University Cancer Hospital and Institute, Beijing, China.
Annals of Surgical Oncology
|May 9, 2025
Summary
Predicting chemotherapy response in colorectal liver metastasis (CRLM) is possible using genetic mutations and patient factors. This can help personalize treatment and potentially avoid unnecessary biological targeted agents (BTAs).
Area of Science:
- Oncology
- Genetics
- Molecular Biology
Background:
- Colorectal liver metastasis (CRLM) presents challenges in predicting chemotherapy response.
- Identifying predictive factors is crucial for optimizing treatment strategies in CRLM patients.
Purpose of the Study:
- To identify predictive factors for chemotherapy response in patients with colorectal liver metastasis (CRLM).
- To develop a model for predicting treatment efficacy and guiding the use of biological targeted agents (BTAs).
Main Methods:
- Retrospective analysis of 230 CRLM patients undergoing chemotherapy.
- DNA sequencing of tumor tissues to identify gene mutations.
- Comparative analysis of oncogenic pathways and logistic regression for predictive factor identification.
Main Results:
- Significant differences in KRAS gene mutations, rare gene mutations (EP300, PTPRK, KMT2A, ACVR1B), and PI3K/RTK-RAS pathways were observed between responders and non-responders.
- A prediction model incorporating gender, BTA use, KRAS mutations, PI3K alterations, and rare mutations achieved an AUC of 0.73.
- The model predicted that approximately 75% of patients could potentially avoid BTAs, and identified non-responders who might benefit from BTA inclusion.
Conclusions:
- Gender, BTA utilization, and specific gene/pathway mutations are significant predictors of chemotherapy response in CRLM.
- Genetic profiling offers a valuable tool for refining treatment strategies and personalizing care for CRLM patients.
