Learning objectives
Systematically review the literature of predictive biomarkers in blood for assessing neoadjuvant chemoradiation response in LARC.
Background
Methods
A systematic search of electronic databases (MEDLINE, PubMed and EMBASE) was performed for relevant studies published until November 2019.
Studies were screened as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flowchart.
The relevant studies were selected for full-text review.
Inclusion / Exclusion Criteria
Studies that met the following criteria were included: human published studies with patients diagnosed with locoregional advanced rectal adenocarcinoma (T3/T4 tumours and/or nodal disease); patients whom received neoadjuvant long-course chemoradiation followed by surgery with concurrent chemotherapy; studies...
Imaging findings OR Procedure details
We included 83 studies with a total of 20826 patients.
38 studies assessed blood systemic inflammatory response markers, such as haemoglobin, neutrophil, lymphocyte, albumin, platelets, fibrinogen, interleukins, cytokines and chemokines.
32 studies assessed tumour markers such as CEA and CA 19.9.
25 studies assessed other markers such as single nucleotide polymorphisms, microRNA, circulating tumour cells, circulating or cell free DNA or RNA (see Figure 1).
Conclusion
The use of blood biomarkers such as CEA may be predictive for pathological response in patients with locally advanced rectal cancer receiving neoadjuvant chemoradiation.
This is limited by the heterogeneity in the studies.
Personal information
M. Or:
Nothing to disclose
References
1.Maas M, Nelemans PJ, Valentini V, et al. Long-term outcome in patients with a pathological complete response after chemoradiation for rectal cancer: a pooled analysis of individual patient data. The Lancet Oncology 2010;11:835-44.
2.Janjan NA, Khoo VS, Abbruzzese J, et al. Tumor downstaging and sphincter preservation with preoperative chemoradiation in locally advanced rectal cancer: the M. D. Anderson Cancer Center experience. Int J Radiat Oncol Biol Phys 1999;44:1027-38.
3.Habr-Gama A, Perez RO, Nadalin W, et al. Operative versus nonoperative treatment for stage 0 distal rectal...