Characteristics of Patients and Prognostic Factors Across Treatment Lines in Metastatic Colorectal Cancer: An Analysis From the Aide et Recherche en Cancérologie Digestive Database

作者：Jean‐Baptiste Bachet, Aimery de Gramont, Morteza Raeisi, Manel Rakez, Richard M. Goldberg, Niall C. Tebbutt, Eric Van Cutsem, Daniel G. Haller, J. Randolph Hecht, R. Mayer, Stuart M. Lichtman, Al B. Benson, Alberto F. Sobrero, Josep Tabernero, Richard Adams, John Zalcberg, Axel Grothey, Takayuki Yoshino, Thierry André, Qian Shi, Benoist Chibaudel · 发表于：Journal of Clinical Oncology · 年份：2025 · DOI：10.1200/jco-24-01968 · 被引用次数：8 · 研究领域：Colorectal Cancer Treatments and Studies、Colorectal Cancer Surgical Treatments、Colorectal Cancer Screening and Detection

PURPOSE Several 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 METHODS Individual 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. RESULTS A 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 ...