Researchers from Université de Tours have shown that serum mid-infrared spectroscopy (MIRS) may serve as a promising prognostic tool for identifying high-risk metastatic colorectal cancer patients undergoing first-line bevacizumab-based chemotherapy.
In a recent study, a team of researchers from several French institutions collaborated on building a new tool for patients afflicted with metastatic colorectal cancer (mCRC) receiving first-line bevacizumab-based chemotherapy. This study, which was published in Digestive and Liver Disease, was led by Dr. Romain Chautard, and it suggests that mid-infrared (MIR) spectroscopy could help identify high-risk patients earlier in the treatment process, potentially enabling more personalized care strategies (1).
Bevacizumab-based chemotherapy has long been a frontline standard for treating mCRC, but clinicians have struggled to identify robust biomarkers that could predict how individual patients will respond (2). Without such markers, tailoring therapy to optimize outcomes remains difficult (1). As it stands, patients with mCRC need to be administered treatment carefully because they could respond to therapies differently. Some patients even experience life-threatening side effects, including kidney problems and serious bleeding (2).
In this study, the research team attempts to show how their research sheds light on how metabolomic fingerprinting through MIR spectroscopy may offer a solution. The study is an ancillary analysis derived from a multicenter prospective trial (NCT00489697) (1). In this trial, baseline serum samples from 108 mCRC patients undergoing first-line bevacizumab-based chemotherapy were analyzed using the attenuated total reflection (ATR) method, a MIR technique that captures the biochemical composition of blood serum (1). To identify two distinct prognostic groups based on serum spectral patterns, the research team used principal component analysis (PCA) and unsupervised k-means partitioning (1).
The research team found that patients in one of the groups were characterized by lower body mass index (p = 0.026) and albumin levels (p < 0.001), along with elevated levels of angiogenic markers, lactate dehydrogenase, and carcinoembryonic antigen (p < 0.001) (1). These biomarkers are typically associated with poor prognosis, and indeed, the corresponding group showed significantly shorter progression-free survival (PFS) and overall survival (OS) (1).
In univariate analysis, the median PFS for this group was 8.7 months compared to 11.3 months for the other group (p = 0.03) (1). The median OS was 17.6 months compared to 27.9 months (p = 0.02) (1). Multivariate analysis further confirmed the association, with hazard ratios of 1.74 (p = 0.025) for PFS and 1.69 (p = 0.061) for OS (1).
There were several key limitations in this study that the authors acknowledged in their article. As an example, their study did not include key clinical and molecular data such as tumor laterality and microsatellite instability status (1). These are important factors in colorectal cancer prognosis and could affect the interpretation of the MIR spectroscopy findings. Additionally, the study’s sample size, while larger than previous retrospective efforts, still calls for cautious interpretation (1).
Nonetheless, the researchers are optimistic based on their results that MIR spectroscopy can lead to improved metabolic fingerprinting that is rapid and non-invasive. As the researchers showed in their study, MIR spectroscopy can potentially identify patients who are at a significantly higher risk of progression despite receiving standard-of-care therapy (1). As a result, the researchers believe that their work can help result in early interventions with alternative or intensified treatment approaches (1)
The study underscores the need for further validation in larger, standardized trials. Such research could confirm whether MIR spectroscopy can reliably serve as a prognostic tool and become integrated into clinical decision-making processes for mCRC. As oncologists continue to seek methods that enhance the precision and effectiveness of cancer care, tools like serum MIR spectroscopy could become valuable additions to the clinical arsenal.
