Baseline CT-derived tumor burden and liquid biopsy as biomarkers to predict survival in patients with metastatic solid cancer.

IF 8.1 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Diagnostic and Interventional Imaging Pub Date : 2025-06-07 DOI:10.1016/j.diii.2025.06.002

Ghina Jardali, Littisha Lawrance, Lama Dawi, Jules Dupont, Othilie Gautier, Michèle Kind, Samy Ammari, Joya Hadchiti, Aurélie Choucair, Arnaud Bayle, Paul-Henry Cournède, Isabelle Borget, Serge Muller, François Bidault, Corinne Balleyguier, Antoine Hollebecque, Yohann Loriot, Filippo Gustavo Dall-Olio, Benjamin Besse, Ludovic Lacroix, Etienne Rouleau, Alexandre Bône, Fabrice André, Christophe Massard, Fabrice Barlesi, Antoine Italiano, Nathalie Lassau

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引用次数: 0

Abstract

Purpose: The purpose of this study was to evaluate baseline tumor burden from liquid biopsy (LB) and computed tomography (CT) as prognostic biomarkers and whether their combination refines stratification in metastatic solid cancers.

Materials and methods: This retrospective cohort study included 1065 patients. Eligible patients underwent LB and chest-abdomen-pelvis CT examination at baseline. Radiologists outlined lesions on the largest axial slice, and total tumor volume (TTV) was approximated in three dimensions. LB Tumor fraction (TF) ≥ 10 % was considered high. To assess combined prognostic power of LB and TTV, patients were divided into three groups according to LB (circulating tumor deoxyribonucleic acid [ctDNA] detectability and TF) and each group was further divided into two subgroups using TTV thresholds determined by Youden's index. Overall survival (OS) analyses were performed using Cox proportional hazard models and Kaplan-Meier curves.

Results: A total of 560 patients (290 women and 270 men; median age, 61 years) with 31,314 annotated lesions were selected. The median OS was 11.28 months, and the median TTV was 96.68 cm³. The LB groups included patients with undetectable ctDNA (n = 102), patients with detectable ctDNA and low TF (n = 251), and patients with high TF (n = 207). Integrating TTV thresholds (18.7 cm³, 44.9 cm³, and 159.94 cm³) to LB groups significantly stratified the population on OS. Patients with undetectable ctDNA and TTV ≥ 18.7 cm³ had significantly shorter OS (median OS, 24.8 months) than those with TTV < 18.7 cm³ (median OS, > 35 months).

Conclusion: Combining baseline CT tumor burden with LB could be a valuable prognostic tool for stratifying patients with metastatic solid cancer.

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基线ct衍生肿瘤负荷和液体活检作为预测转移性实体癌患者生存的生物标志物。

目的：本研究的目的是评估液体活检（LB）和计算机断层扫描（CT）作为预后生物标志物的基线肿瘤负荷，以及它们的结合是否可以改善转移性实体癌的分层。材料和方法：本回顾性队列研究纳入1065例患者。符合条件的患者在基线时接受LB和胸腹骨盆CT检查。放射科医生在最大的轴向切片上勾勒出病变轮廓，并在三维上近似计算肿瘤总体积（TTV）。肿瘤分数(TF)≥10%为高。为了评估LB和TTV的联合预后能力，根据LB（循环肿瘤脱氧核糖核酸[ctDNA]的检测能力和TF）将患者分为三组，并根据约登指数确定的TTV阈值将每组患者进一步分为两个亚组。采用Cox比例风险模型和Kaplan-Meier曲线进行总生存率（OS）分析。结果：共560例患者(女性290例，男性270例；中位年龄61岁)，选择31,314个带注释的病变。中位OS为11.28个月，中位TTV为96.68 cm3。LB组包括ctDNA检测不到的患者（n = 102）、ctDNA检测到但TF低的患者（n = 251）和TF高的患者（n = 207）。将TTV阈值（18.7 cm3, 44.9 cm3和159.94 cm3）整合到LB组中，显著地将总体按OS分层。ctDNA检测不清且TTV≥18.7 cm3的患者的生存期（中位生存期，24.8个月）明显短于TTV < 18.7 cm3的患者（中位生存期，35个月）。结论：将基线CT肿瘤负荷与LB相结合可能是转移性实体癌患者分层的一种有价值的预后工具。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diagnostic and Interventional Imaging Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

8.50

自引率

29.10%

发文量

126

审稿时长

11 days

期刊介绍： Diagnostic and Interventional Imaging accepts publications originating from any part of the world based only on their scientific merit. The Journal focuses on illustrated articles with great iconographic topics and aims at aiding sharpening clinical decision-making skills as well as following high research topics. All articles are published in English. Diagnostic and Interventional Imaging publishes editorials, technical notes, letters, original and review articles on abdominal, breast, cancer, cardiac, emergency, forensic medicine, head and neck, musculoskeletal, gastrointestinal, genitourinary, interventional, obstetric, pediatric, thoracic and vascular imaging, neuroradiology, nuclear medicine, as well as contrast material, computer developments, health policies and practice, and medical physics relevant to imaging.