Predicting response to neoadjuvant chemoradiotherapy in locally advanced rectal cancer with serum biomarkers.

2.50
Hdl Handle:
http://hdl.handle.net/11287/620362
Title:
Predicting response to neoadjuvant chemoradiotherapy in locally advanced rectal cancer with serum biomarkers.
Authors:
Clarke, T L; White, D. A.; Osborne, Melanie; Shaw, A M; Smart, Neil J. ( 0000-0002-3043-8324 ) ; Daniels, Ian R. ( 0000-0002-9114-0812 )
Abstract:
Introduction The aim of this study was to identify patient factors including serum biomarkers that may predict response to neoadjuvant chemoradiotherapy (CRT) in patients with locally advanced rectal cancer staged on magnetic resonance imaging. Prediction of response may be helpful when selecting patients for a non-operative programme. Methods A retrospective review was carried out of patients undergoing neoadjuvant CRT for rectal cancer, conducted at the Royal Devon and Exeter Hospital. All patients were managed through the multidisciplinary team. Receiver operating characteristic (ROC) curve analysis was undertaken to assess the ability of biomarkers to predict response to neoadjuvant CRT. The biomarkers assessed included neutrophils, lymphocytes, monocytes, haemoglobin, platelets, C-reactive protein and carcinoembryonic antigen. Results Seventy-three patients underwent neoadjuvant CRT between January 2006 and December 2011. Nine (12.3%) of these experienced a clinical complete response and were managed with a 'watch and wait' approach. An additional ten patients (13.7%) had a pathological complete response following surgery. Using ROC curve analysis, the biomarkers with the largest area under the curve (AUC) were pre-CRT haemoglobin and post-CRT lymphocyte concentrations, producing AUC values of 0.673 and 0.618 respectively for clinical complete response. Pre-CRT haemoglobin and neutrophil concentrations produced the highest AUC values for pathological complete response at 0.591 and 0.614 respectively. Conclusions None of the assessed biomarkers offer the ability to predict response to neoadjuvant CRT in patients with rectal cancer. They cannot therefore assist in identifying complete clinical or pathological responders who could be considered for a non-operative, observational approach.
Citation:
Predicting response to neoadjuvant chemoradiotherapy in locally advanced rectal cancer with serum biomarkers. 2017, 99 (5):373-377 Ann R Coll Surg Engl
Publisher:
Royal College of Surgeons
Journal:
Annals of the Royal College of Surgeons of England
Issue Date:
May-2017
URI:
http://hdl.handle.net/11287/620362
DOI:
10.1308/rcsann.2017.0030
PubMed ID:
28462648
Additional Links:
http://publishing.rcseng.ac.uk/doi/abs/10.1308/rcsann.2017.0030?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmed
Type:
Journal Article
Language:
en
ISSN:
1478-7083
Appears in Collections:
Colorectal Surgery; HeSRU publications; Oncology; 2017 RD&E publications

Full metadata record

DC FieldValue Language
dc.contributor.authorClarke, T Len
dc.contributor.authorWhite, D. A.en
dc.contributor.authorOsborne, Melanieen
dc.contributor.authorShaw, A Men
dc.contributor.authorSmart, Neil J.en
dc.contributor.authorDaniels, Ian R.en
dc.date.accessioned2017-07-20T12:40:38Z-
dc.date.available2017-07-20T12:40:38Z-
dc.date.issued2017-05-
dc.identifier.citationPredicting response to neoadjuvant chemoradiotherapy in locally advanced rectal cancer with serum biomarkers. 2017, 99 (5):373-377 Ann R Coll Surg Englen
dc.identifier.issn1478-7083-
dc.identifier.pmid28462648-
dc.identifier.doi10.1308/rcsann.2017.0030-
dc.identifier.urihttp://hdl.handle.net/11287/620362-
dc.description.abstractIntroduction The aim of this study was to identify patient factors including serum biomarkers that may predict response to neoadjuvant chemoradiotherapy (CRT) in patients with locally advanced rectal cancer staged on magnetic resonance imaging. Prediction of response may be helpful when selecting patients for a non-operative programme. Methods A retrospective review was carried out of patients undergoing neoadjuvant CRT for rectal cancer, conducted at the Royal Devon and Exeter Hospital. All patients were managed through the multidisciplinary team. Receiver operating characteristic (ROC) curve analysis was undertaken to assess the ability of biomarkers to predict response to neoadjuvant CRT. The biomarkers assessed included neutrophils, lymphocytes, monocytes, haemoglobin, platelets, C-reactive protein and carcinoembryonic antigen. Results Seventy-three patients underwent neoadjuvant CRT between January 2006 and December 2011. Nine (12.3%) of these experienced a clinical complete response and were managed with a 'watch and wait' approach. An additional ten patients (13.7%) had a pathological complete response following surgery. Using ROC curve analysis, the biomarkers with the largest area under the curve (AUC) were pre-CRT haemoglobin and post-CRT lymphocyte concentrations, producing AUC values of 0.673 and 0.618 respectively for clinical complete response. Pre-CRT haemoglobin and neutrophil concentrations produced the highest AUC values for pathological complete response at 0.591 and 0.614 respectively. Conclusions None of the assessed biomarkers offer the ability to predict response to neoadjuvant CRT in patients with rectal cancer. They cannot therefore assist in identifying complete clinical or pathological responders who could be considered for a non-operative, observational approach.en
dc.language.isoenen
dc.publisherRoyal College of Surgeonsen
dc.relation.urlhttp://publishing.rcseng.ac.uk/doi/abs/10.1308/rcsann.2017.0030?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmeden
dc.rightsArchived with thanks to Annals of the Royal College of Surgeons of Englanden
dc.subjectWessex Classification Subject Headings::Gastroenterologyen
dc.subjectWessex Classification Subject Headings::Oncology. Pathology.en
dc.titlePredicting response to neoadjuvant chemoradiotherapy in locally advanced rectal cancer with serum biomarkers.en
dc.typeJournal Articleen
dc.identifier.journalAnnals of the Royal College of Surgeons of Englanden
dc.type.versionPublisheden

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