Toward Personalized Radiation Therapy of Liver Metastasis: Importance of Serial Blood Biomarkers

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Ali Ajdari - (Author)
  • Yunhe Xie - (Author)
  • Christian Richter - , Department of Radiotherapy and Radiooncology, OncoRay - National Centre for Radiation Research in Oncology (Author)
  • Maximilian Niyazi - (Author)
  • Dan G. Duda - (Author)
  • Theodore S. Hong - (Author)
  • Thomas Bortfeld - (Author)

Abstract

PURPOSE To assess the added value of serial blood biomarkers in liver metastasis stereotactic body radiation therapy (SBRT). MATERIALS AND METHODS Eighty-nine patients were retrospectively included. Pre- and midtreatment blood samples were analyzed for potential biomarkers of the treatment response. Three biomarker classes were studied: gene mutation status, complete blood count, and inflammatory cytokine concentration in plasma. One-year local failure (LF) and 2-year overall survival (OS) were chosen as study end points. Multivariate logistic regression was used for response prediction. Added predictive benefit was assessed by quantifying the difference between the predictive performance of a baseline model (clinicopathologic and dosimetric predictors) and that of the biomarker-enhanced model, using three metrics: (1) likelihood ratio, (2) predictive variance, and (3) area under the receiver operating characteristic curve (AUC). RESULTS The most important predictors of LF were mutation in KRAS gene (hazard ratio [HR] = 2.92, 95% CI, [1.17 to 7.28], P = .02) and baseline and midtreatment concentration of plasma interleukin-6 (HR = 1.15 [1.04 to 1.26] and 1.06 [1.01 to 1.13], P = .01). Absolute lymphocyte count and platelet-to-lymphocyte ratio at baseline as well as neutrophil-to-lymphocyte ratio at baseline and before fraction 3 (HR = 1.33 [1.16 to 1.51] and 1.19 [1.09 to 1.30]) had the most significant association with OS (P = .0003). Addition of baseline GEN and inflammatory plasma cytokine biomarkers in predicting LF, respectively, increased AUC by 0.06 (from 0.73 to 0.79) and 0.07 (from 0.77 to 0.84). In predicting OS, inclusion of midtreatment complete blood count biomarkers increased AUC from 0.72 to 0.80, along with significant boosts in likelihood ratio and predictive variance. CONCLUSION Inclusion of serial blood biomarkers leads to significant gain in predicting response to liver metastasis stereotactic body radiation therapy and can guide treatment personalization.

Details

Original languageEnglish
Pages (from-to)315-325
Number of pages11
Journal JCO clinical cancer informatics : an American Society of Clinical Oncology journal
Volume5
Publication statusPublished - Dec 2021
Peer-reviewedYes

External IDs

Scopus 85103505091
Mendeley a36a0214-5f31-3201-9185-d0b870697511

Keywords

ASJC Scopus subject areas