Is Precision Medicine for Colorectal Liver Metastases Still a Utopia? New Perspectives by Modern Biomarkers, Radiomics, and Artificial Intelligence

Overview

Journal World J Gastroenterol

Publisher Baishideng Publishing Group

Specialty Gastroenterology

Date 2022 Mar 23

PMID 35317421

Authors

Luca Vigano

Visala S Jayakody Arachchige

Francesco Fiz

Affiliations

Soon will be listed here.

Abstract

The management of patients with liver metastases from colorectal cancer is still debated. Several therapeutic options and treatment strategies are available for an extremely heterogeneous clinical scenario. Adequate prediction of patients' outcomes and of the effectiveness of chemotherapy and loco-regional treatments are crucial to reach a precision medicine approach. This has been an unmet need for a long time, but recent studies have opened new perspectives. New morphological biomarkers have been identified. The dynamic evaluation of the metastases across a time interval, with or without chemotherapy, provided a reliable assessment of the tumor biology. Genetics have been explored and, thanks to their strong association with prognosis, have the potential to drive treatment planning. The liver-tumor interface has been identified as one of the main determinants of tumor progression, and its components, in particular the immune infiltrate, are the focus of major research. Image mining and analyses provided new insights on tumor biology and are expected to have a relevant impact on clinical practice. Artificial intelligence is a further step forward. The present paper depicts the evolution of clinical decision-making for patients affected by colorectal liver metastases, facing modern biomarkers and innovative opportunities that will characterize the evolution of clinical research and practice in the next few years.

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References

Beckers R, Trebeschi S, Maas M, Schnerr R, Sijmons J, Beets G . CT texture analysis in colorectal liver metastases and the surrounding liver parenchyma and its potential as an imaging biomarker of disease aggressiveness, response and survival. Eur J Radiol. 2018; 102:15-21. DOI: 10.1016/j.ejrad.2018.02.031. View

Lang H, Baumgart J, Heinrich S, Tripke V, Passalaqua M, Maderer A . Extended Molecular Profiling Improves Stratification and Prediction of Survival After Resection of Colorectal Liver Metastases. Ann Surg. 2019; 270(5):799-805. DOI: 10.1097/SLA.0000000000003527. View

Lambin P, Leijenaar R, Deist T, Peerlings J, de Jong E, van Timmeren J . Radiomics: the bridge between medical imaging and personalized medicine. Nat Rev Clin Oncol. 2017; 14(12):749-762. DOI: 10.1038/nrclinonc.2017.141. View

Konopke R, Kersting S, Distler M, Dietrich J, Gastmeier J, Heller A . Prognostic factors and evaluation of a clinical score for predicting survival after resection of colorectal liver metastases. Liver Int. 2008; 29(1):89-102. DOI: 10.1111/j.1478-3231.2008.01845.x. View

Vigano L . Treatment strategy for colorectal cancer with resectable synchronous liver metastases: Is any evidence-based strategy possible?. World J Hepatol. 2012; 4(8):237-41. PMC: 3443705. DOI: 10.4254/wjh.v4.i8.237. View

Adam R, de Haas R, Wicherts D, Aloia T, Delvart V, Azoulay D . Is hepatic resection justified after chemotherapy in patients with colorectal liver metastases and lymph node involvement?. J Clin Oncol. 2008; 26(22):3672-80. DOI: 10.1200/JCO.2007.15.7297. View

Rao S, Lambregts D, Schnerr R, Beckers R, Maas M, Albarello F . CT texture analysis in colorectal liver metastases: A better way than size and volume measurements to assess response to chemotherapy?. United European Gastroenterol J. 2016; 4(2):257-63. PMC: 4804371. DOI: 10.1177/2050640615601603. View

Adam R, Pascal G, Castaing D, Azoulay D, Delvart V, Paule B . Tumor progression while on chemotherapy: a contraindication to liver resection for multiple colorectal metastases?. Ann Surg. 2004; 240(6):1052-61. PMC: 1356520. DOI: 10.1097/01.sla.0000145964.08365.01. View

Allard M, Adam R, Giuliante F, Lapointe R, Hubert C, IJzermans J . Long-term outcomes of patients with 10 or more colorectal liver metastases. Br J Cancer. 2017; 117(5):604-611. PMC: 5572175. DOI: 10.1038/bjc.2017.218. View

10.

Vauthey J, Zimmitti G, Kopetz S, Shindoh J, Chen S, Andreou A . RAS mutation status predicts survival and patterns of recurrence in patients undergoing hepatectomy for colorectal liver metastases. Ann Surg. 2013; 258(4):619-26. PMC: 3856211. DOI: 10.1097/SLA.0b013e3182a5025a. View

11.

van Timmeren J, Cester D, Tanadini-Lang S, Alkadhi H, Baessler B . Radiomics in medical imaging-"how-to" guide and critical reflection. Insights Imaging. 2020; 11(1):91. PMC: 7423816. DOI: 10.1186/s13244-020-00887-2. View

12.

Elias D, Vigano L, Orsi F, Scorsetti M, Comito T, Lerut J . New Perspectives in the Treatment of Colorectal Metastases. Liver Cancer. 2016; 6(1):90-98. PMC: 5159732. DOI: 10.1159/000449492. View

13.

Vigano L, Capussotti L, Majno P, Toso C, Ferrero A, De Rosa G . Liver resection in patients with eight or more colorectal liver metastases. Br J Surg. 2014; 102(1):92-101. DOI: 10.1002/bjs.9680. View

14.

Gurusamy K, Corrigan N, Croft J, Twiddy M, Morris S, Woodward N . Liver resection surgery versus thermal ablation for colorectal LiVer MetAstases (LAVA): study protocol for a randomised controlled trial. Trials. 2018; 19(1):105. PMC: 5811975. DOI: 10.1186/s13063-018-2499-5. View

15.

Torzilli G, Adam R, Vigano L, Imai K, Goransky J, Fontana A . Surgery of Colorectal Liver Metastases: Pushing the Limits. Liver Cancer. 2016; 6(1):80-89. PMC: 5159716. DOI: 10.1159/000449495. View

16.

Vigano L, Torzilli G, Cimino M, Imai K, Vibert E, Donadon M . Drop-out between the two liver resections of two-stage hepatectomy. Patient selection or loss of chance?. Eur J Surg Oncol. 2016; 42(9):1385-93. DOI: 10.1016/j.ejso.2016.03.020. View

17.

Sagawa T, Sato Y, Hirakawa M, Hamaguchi K, Fukuya A, Okamoto K . Clinical impact of primary tumour location, early tumour shrinkage, and depth of response in the treatment of metastatic colorectal cancer with first-line chemotherapy plus cetuximab or bevacizumab. Sci Rep. 2020; 10(1):19815. PMC: 7666202. DOI: 10.1038/s41598-020-76756-1. View

18.

Yokota T, Ura T, Shibata N, Takahari D, Shitara K, Nomura M . BRAF mutation is a powerful prognostic factor in advanced and recurrent colorectal cancer. Br J Cancer. 2011; 104(5):856-62. PMC: 3048210. DOI: 10.1038/bjc.2011.19. View

19.

Nordlinger B, Sorbye H, Glimelius B, Poston G, Schlag P, Rougier P . Perioperative chemotherapy with FOLFOX4 and surgery versus surgery alone for resectable liver metastases from colorectal cancer (EORTC Intergroup trial 40983): a randomised controlled trial. Lancet. 2008; 371(9617):1007-16. PMC: 2277487. DOI: 10.1016/S0140-6736(08)60455-9. View

20.

Brouquet A, Overman M, Kopetz S, Maru D, Loyer E, Andreou A . Is resection of colorectal liver metastases after a second-line chemotherapy regimen justified?. Cancer. 2011; 117(19):4484-92. PMC: 3128184. DOI: 10.1002/cncr.26036. View