Combining 18F-FDG PET/CT–Based Metabolically Active Tumor Volume and Circulating Cell-Free DNA Significantly Improves Outcome Prediction in Chemorefractory Metastatic Colorectal Cancer

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FIGURE 1.
Baseline cfDNA parameter categorized into low- and high-value groups and its corresponding OS (A) and PFS (B).
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FIGURE 2.
Baseline WB-MATV parameter categorized into low- and high-value groups and its corresponding OS (A) and PFS (B).
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FIGURE 3.
Combined baseline cfDNA and WB-MATV parameters resulting in categorization into 3 distinct groups of patients with significantly different median OS.

TABLE 1

Patient and Disease Characteristics of Evaluable Patients (n = 132)

Characteristic	Value
Age (y)
Median	67
Range	32–85
Sex (n)
Male	76 (58%)
Female	56 (42%)
Body mass index
Median	24
Range	14–41
Eastern Cooperative Oncology Group performance status (n)
0	63 (48%)
1	69 (52%)
Primary site of disease (n)
Colon	98 (74%)
Rectum	34 (26%)
Time from diagnosis to inclusion (y)
Median	3.3
Range	0.1–13.0
Prior use of bevacizumab (n)
Yes	102 (77%)
No	30 (23%)
KRAS (n)
Wild-type	60 (46%)
Mutant	71 (54%)
Unknown	1 (<1%)

TABLE 2

Univariate Analyses of Baseline cfDNA and WB-MATV on Clinical Outcomes (PFS and OS)

TABLE 4

Multivariate Analysis of Baseline cfDNA, WB-MATV, and Clinical Parameters on PFS and OS

	PFS				OS
Parameter	Prognostic weight	Parameter estimate	P	HR	Prognostic weight	Parameter estimate	P	HR
cfDNA ≥ 50 ng/mL	6	0.92	<0.001	2.51 (1.69–3.73)	9	0.90	<0.001	2.46 (1.51–4.03)
WB-MATV ≥ 100 cm³	—	—	—	—	6	0.62	0.016	1.87 (1.12–3.10)
Years since diagnosis (per 1-y increase)	−1	−0.17	<0.001	0.85 (0.79–0.91)	−1	−0.10	0.010	0.91 (0.84–0.98)
Body mass index ≥ 30	−3	−0.53	0.031	0.59 (0.36–0.95)	−8	−0.80	0.002	0.45 (0.27–0.75)
ECOG-PS 1	—	—	—	—	5	0.46	0.014	1.58 (1.10–2.28)