An ARCAD database nomogram for prognostic prediction of treatment refractory metastatic colorectal cancer.

Authors

Eiji Oki

Eiji Oki

Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University Hospital, Fukuoka, Japan

Eiji Oki , Hideaki Bando , Kentaro Yamazaki , Toshihiro Misumi , Yuriko Takeda , Motoko Suzuki , Masashi Wakabayashi , Axel Grothey , Robert J. Mayer , Jin Li , Thierry Andre , Qian Shi , Aimery De Gramont , Takayuki Yoshino

Organizations

Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University Hospital, Fukuoka, Japan, Division of Drug and Diagnostic Development Promotion, Department for the Promotion of Drug and Diagnostic Development, National Cancer Center Hospital East, Kashiwa, Japan, Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Shizuoka, Japan, Department of Data Science, National Cancer Center Hospital East, Kashiwa, Japan, Clinical Research Support Office, National Cancer Center Hospital East, Kashiwa, Japan, West Cancer Center, Germantown, TN, Dana-Farber Cancer Institute, Boston, MA, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China, Hôpital Saint-Antoine, Paris, France, Department of Quantitative Science Research, Mayo Clinic, Rochester, MN, Institut Hospitalier Franco-Britannique, Levallois-Perret, France

Research Funding

ARCAD asia

Background: The "No Placebo Initiative" demonstrated that the survivals of patients (pts) receiving placebo in a salvage-line setting, exhibited no significant difference across trials (CORRECT, RECOURSE, CONCUR and TERRA). Therefore, we believe that a nomogram can be generated using the ARCAD database to predict survival of pts who completed standard therapy. Methods: Of 40,889 Individual patient data (IPD) from 59 studies, 723 pts received placebo from 4 randomized studies were pooled. The potential prognostic factors considered include BMI and Age. Imputed datasets were constructed by a multiple imputation method since the original dataset contains some missing values. Overall survival (OS) was defined as the time from randomization to death from any cause. Multivariate Cox proportional hazards models for OS were estimated based on the variables showing clinically and statistically significant by univariate analysis. Prediction performance of the final model was evaluated using the concordance index for survival data and calibration plots. Results: From univariate and multivariate analysis, ECOG performance status, Royal Marsden Hospital score (calculated by albumin level, LDH level, and number of metastatic site), primary site location, liver meta, peritoneal meta were selected as variables. We successfully developed a highly accurate nomogram to predict post-standard treatment prognosis for pts with mCRC. Concordance index for OS was 0.66. Conclusions: Although further validation in other cohorts is needed, this nomogram could be very useful to estimate the survival for clinical practice and enrolling in clinical trials.

Data used to create the nomogram.

UnivariateMultivariate
HR95%CIPHR95%CIP
Performance status<0.0001<0.0001
 0(Reference)(Reference)
 11.481.24-1.751.571.31-1.89
Gender0.3502
 Female(Reference)
 Male0.920.78-1.09
Age at enrollment1.011.00-1.020.03281.001.00-1.010.3979
BMI0.980.96-1.000.01560.990.97-1.010.3188
Albumin (g/L)0.990.98-0.990.0071
LDH (U/L)1.001.00-1.000.0039
N of Metastatic Sites<0.0001
 1(Reference)
 2+1.771.39-2.25
Royal Marsden Hospital score<0.00010.0028
 0-1(Reference)(Reference)
 2-31.841.50-2.261.751.2-2.52
Primary Site Location0.01400.0217
 Colon(Reference)(Reference)
 Rectum0.800.67-0.960.800.67-0.97
Liver metastases<0.0001<0.0001
 No(Reference)(Reference)
 Yes1.781.48-2.151.661.36-2.02
Lung metastases0.3890
 No(Reference)
 Yes1.090.90-1.33
Peritoneal metastases0.00010.0011
 No(Reference)(Reference)
 Yes1.721.30-2.261.631.22-2.19
Stage at diagnosis0.1946
 I-III(Reference)
 IV1.170.92-1.47

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Abstract Details

Meeting

2024 ASCO Gastrointestinal Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session C: Cancers of the Colon, Rectum, and Anus

Track

Colorectal Cancer,Anal Cancer

Sub Track

Therapeutics

Citation

J Clin Oncol 42, 2024 (suppl 3; abstr 107)

DOI

10.1200/JCO.2024.42.3_suppl.107

Abstract #

107

Poster Bd #

G11

Abstract Disclosures

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