Targeted therapy acts to sensitize stereotactic body radiotherapy for pulmonary oligometastases from colorectal cancer

BackgroundStereotactic body radiation therapy (SBRT) is used to manage lung metastases arising from colorectal cancer (CRC), but its effectiveness is constrained by the radioresistance of CRCs. Here, we explored whether concurrent therapy with cetuximab or bevacizumab could improve the prognosis of...

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Main Authors: Xiye Sun, Pei Shu, Yali Shen, Zhiping Li, Ning Liu, Ganlu Ouyang, Yuanling Tang, Meijuan Huang, Xin Wang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Oncology
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Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2025.1464707/full
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author Xiye Sun
Pei Shu
Pei Shu
Yali Shen
Zhiping Li
Ning Liu
Ganlu Ouyang
Yuanling Tang
Meijuan Huang
Xin Wang
author_facet Xiye Sun
Pei Shu
Pei Shu
Yali Shen
Zhiping Li
Ning Liu
Ganlu Ouyang
Yuanling Tang
Meijuan Huang
Xin Wang
author_sort Xiye Sun
collection DOAJ
description BackgroundStereotactic body radiation therapy (SBRT) is used to manage lung metastases arising from colorectal cancer (CRC), but its effectiveness is constrained by the radioresistance of CRCs. Here, we explored whether concurrent therapy with cetuximab or bevacizumab could improve the prognosis of CRC patients with pulmonary oligometastases.Materials and methodsCRC patients with oligometastatic lung tumors (OLTs) treated with concurrent chemoradiotherapy from March 2011 to March 2023 were retrospectively analyzed. Treatment outcomes for local control rate (LCR), progression-free survival (PFS), overall survival (OS), and toxicities were assessed.ResultsSixty-nine patients were included, with a median follow-up of 34 months. The 1-year LCRs for SBRT + chemotherapy, SBRT + chemotherapy + bevacizumab, and SBRT + chemotherapy + cetuximab were 63.3%, 96.2%, and 94.4%, respectively. Incorporating bevacizumab or cetuximab significantly prolonged median OS compared to chemotherapy (61 vs. 46 vs. 24 months). Substantial differences in median PFS were noted, with durations of 5, 23, and 8 months for SBRT + chemotherapy, SBRT + chemotherapy + bevacizumab, and SBRT + chemotherapy + cetuximab, respectively. Our univariate analysis revealed that patients under targeted therapy of bevacizumab or cetuximab were linked to prolonged OS and PFS (p < 0.05). Tumor size <2 cm and median biologically effective dose (BED10) ≥100 Gy were correlated with higher local control rates (p < 0.05). Furthermore, comprehensive multivariate analysis confirmed that tumor sizes of <2 cm were linked to better local control (p < 0.05). All three combination regimens were well tolerated, and the occurrence of toxicities was higher in treatments involving targeted therapy.ConclusionCombining concurrent chemoradiotherapy with cetuximab or bevacizumab improves treatment outcomes, with manageable toxicity. Given the limited sample size of this study, larger studies such as prospective trials are needed.
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spelling doaj-art-607ba833c3ee4abe8bc94667ea1277ff2025-08-20T02:16:17ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-05-011510.3389/fonc.2025.14647071464707Targeted therapy acts to sensitize stereotactic body radiotherapy for pulmonary oligometastases from colorectal cancerXiye Sun0Pei Shu1Pei Shu2Yali Shen3Zhiping Li4Ning Liu5Ganlu Ouyang6Yuanling Tang7Meijuan Huang8Xin Wang9Division of Thoracic Tumor Multimodality Treatment and Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, ChinaDivision of Abdominal Tumor Multimodality Treatment, Department of Radiation Oncology, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaClinical Trial Center, National Medical Products Administration Key Laboratory for Clinical Research and Evaluation of Innovative Drugs, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaDivision of Abdominal Tumor Multimodality Treatment, Department of Radiation Oncology, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaDivision of Abdominal Tumor Multimodality Treatment, Department of Radiation Oncology, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaDivision of Thoracic Tumor Multimodality Treatment and Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, ChinaDivision of Abdominal Tumor Multimodality Treatment, Department of Radiation Oncology, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaDivision of Abdominal Tumor Multimodality Treatment, Department of Radiation Oncology, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaDivision of Thoracic Tumor Multimodality Treatment and Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, ChinaDivision of Abdominal Tumor Multimodality Treatment, Department of Radiation Oncology, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaBackgroundStereotactic body radiation therapy (SBRT) is used to manage lung metastases arising from colorectal cancer (CRC), but its effectiveness is constrained by the radioresistance of CRCs. Here, we explored whether concurrent therapy with cetuximab or bevacizumab could improve the prognosis of CRC patients with pulmonary oligometastases.Materials and methodsCRC patients with oligometastatic lung tumors (OLTs) treated with concurrent chemoradiotherapy from March 2011 to March 2023 were retrospectively analyzed. Treatment outcomes for local control rate (LCR), progression-free survival (PFS), overall survival (OS), and toxicities were assessed.ResultsSixty-nine patients were included, with a median follow-up of 34 months. The 1-year LCRs for SBRT + chemotherapy, SBRT + chemotherapy + bevacizumab, and SBRT + chemotherapy + cetuximab were 63.3%, 96.2%, and 94.4%, respectively. Incorporating bevacizumab or cetuximab significantly prolonged median OS compared to chemotherapy (61 vs. 46 vs. 24 months). Substantial differences in median PFS were noted, with durations of 5, 23, and 8 months for SBRT + chemotherapy, SBRT + chemotherapy + bevacizumab, and SBRT + chemotherapy + cetuximab, respectively. Our univariate analysis revealed that patients under targeted therapy of bevacizumab or cetuximab were linked to prolonged OS and PFS (p < 0.05). Tumor size <2 cm and median biologically effective dose (BED10) ≥100 Gy were correlated with higher local control rates (p < 0.05). Furthermore, comprehensive multivariate analysis confirmed that tumor sizes of <2 cm were linked to better local control (p < 0.05). All three combination regimens were well tolerated, and the occurrence of toxicities was higher in treatments involving targeted therapy.ConclusionCombining concurrent chemoradiotherapy with cetuximab or bevacizumab improves treatment outcomes, with manageable toxicity. Given the limited sample size of this study, larger studies such as prospective trials are needed.https://www.frontiersin.org/articles/10.3389/fonc.2025.1464707/fullstereotactic body radiotherapycolorectal carcinomaoligometastatic lung tumorscetuximabbevacizumab
spellingShingle Xiye Sun
Pei Shu
Pei Shu
Yali Shen
Zhiping Li
Ning Liu
Ganlu Ouyang
Yuanling Tang
Meijuan Huang
Xin Wang
Targeted therapy acts to sensitize stereotactic body radiotherapy for pulmonary oligometastases from colorectal cancer
Frontiers in Oncology
stereotactic body radiotherapy
colorectal carcinoma
oligometastatic lung tumors
cetuximab
bevacizumab
title Targeted therapy acts to sensitize stereotactic body radiotherapy for pulmonary oligometastases from colorectal cancer
title_full Targeted therapy acts to sensitize stereotactic body radiotherapy for pulmonary oligometastases from colorectal cancer
title_fullStr Targeted therapy acts to sensitize stereotactic body radiotherapy for pulmonary oligometastases from colorectal cancer
title_full_unstemmed Targeted therapy acts to sensitize stereotactic body radiotherapy for pulmonary oligometastases from colorectal cancer
title_short Targeted therapy acts to sensitize stereotactic body radiotherapy for pulmonary oligometastases from colorectal cancer
title_sort targeted therapy acts to sensitize stereotactic body radiotherapy for pulmonary oligometastases from colorectal cancer
topic stereotactic body radiotherapy
colorectal carcinoma
oligometastatic lung tumors
cetuximab
bevacizumab
url https://www.frontiersin.org/articles/10.3389/fonc.2025.1464707/full
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