Clin Cancer Res: Intelligent analysis-based genetic characteristics predict the prognosmation of advanced colorectal cancer using Osali platinum first-line chemotherapy

FOLFOX, FOLFIRI, or FOLFOXIRI chemotherapy combined with beva monoantin (BV) are considered standard first-line treatment options for patients with metastatic colorectal cancer (mCRC).
study aims to develop and validate molecular characteristics that predict the efficacy of oxalipal-based chemotherapy combined BV in patients with mCRC.
a machine learning approach and tested clinical and second-generation sequencing data from real-world evidence (RWE) data sets, as well as samples from forward-looking TRIPE2 studies, to identify molecular characteristics of FOLFOXai.
algorithm training takes into account the next treatment time (TTNT).
verification studies used TTNT, Progress-Free Lifetime (PFS) and Total Lifetime (OS) as the primary endpoints.
RWE data set FOLFOX first-line treatment patient prognostication in the training queue (n-105), 67 genetic characteristics were cross-verified, indicating that FOLFOXai has the ability to distinguish between mCRC patients with increased or reduced benefit after FOLFOX treatment (IB).
RWE data set FOLFIRI first-line treatment patient prognosis in 412 patients with FOLFOX/BV as a first-line treatment of the independent RWE data set, the above gene characteristics have a predictive effect on TTTNT and OS, and in 55 patients receiving FOLFIRI as first-line treatment RWE data, the genetic characteristics have the opposite predictive effect on survival.
analysis of the blind method of THETRIBE2 trial FOLFOX first-line treatment of patients with prognostic TRIBE2 trial FOLFIRI first-line treatment confirmed that FOLFOXai had a predictive effect on OS in both groups of patients with Oshali platinum (FOLFOX HR 0.629; p=0.04; FOLFOXIRI 0.483; p=0.02).
FOLFOXai can also predict the therapeutic benefits of the Osali platinum program for advanced esophageal/gastroesophageal junction cancer (EC/GEJC) and pancreatic catheterization adenocarcinoma (PDAC).
addition, the application of FOLFOXai may improve the overall treatment prognosis for mCRC and other cancer patients by promptly selecting potentially beneficial alternatives for patients who are expected to benefit less from the Osari platinum-containing option.