A newly developed scoring system could enhance risk prediction and guide treatment decisions for colorectal cancer, according to a study published in the Journal of Clinical Oncology.
The study, conducted under the ARCAD (Aide et Recherche en Cancérologie Digestive) Clinical Trials Program — a global initiative among scientists specializing in gastrointestinal malignancies to centralize data and accelerate research —integrated patient-level data from dozens of randomized trials.
“The ARCAD database is a wonderful example of collaborative efforts around the world to create large patient-derived datasets that enable expanded research opportunities beyond the initial question addressed in the original design of a clinical trial,” said Al B. Benson III, MD, professor of Medicine in the Division of Hematology and Oncology and a co-author of the study.
In the study, Benson and his collaborators analyzed data from nearly 38,000 patients with metastatic colorectal cancer who were part of 48 clinical trials. They found that seven independent prognostic variables, including key patient and tumor characteristics, were common to all sequential lines of therapy. Using the seven variables — including performance status, hemoglobin levels and the number of tumor locations — investigators developed a standardized score capable of stratifying patients based on survival likelihood.
“The best prognostic group was most frequent, accounting for 36 to 41 percent of patients, with overall survival exceeding 25 months in first-line therapy,” said Benson, who is also a member of the Robert H. Lurie Comprehensive Cancer Center of Northwestern University. “Conversely, the worst prognostic subgroup was the smallest, ranging from 8 to 12 percent, with survival dropping to less than three months in third-line treatment.”
The score showed strong predictive accuracy across all treatments, helping to categorize patients into four distinct risk groups. While the score was not directly predictive of treatment efficacy, Benson said it could refine trial stratification and assist physicians in tailoring therapies more effectively.
“This study demonstrated that the same prognostic model using practical clinical and biological variables can be used in all treatment lines,” Benson said. “Unfortunately, this model cannot predict benefit from treatment and remains a prognostic tool only.”
Benson said the new tool could lead to more personalized approaches in treating colorectal cancer, potentially improving patient outcomes by optimizing treatment plans.
Looking ahead, Benson said that ARCAD is planning to launch a digital application, Score Prognostic in Oncology Digestive, which would allow clinicians to access OPS data via smartphones, tablets or computers.
“Further validation in real-world settings is essential to ensure the model’s applicability across diverse patient populations,” Benson said.
The study was supported by the ARCAD Foundation.
