Chemotherapy outcome predictive effectiveness by the Oncogramme: pilot trial on stage-IV colorectal cancer

Christophe Bounaix Morand Du Puch (1) , Michelle Nouaille (2) , Stéphanie Giraud (1) , Anaïs Labrunie (3) , Sandrine Luce (4) , Pierre-Marie Preux (4, 3) , François Labrousse (5) , Alain Gainant (6) , Nicole Tubiana-Mathieu (7) , Valérie Le Brun-Ly (7) , Denis Valleix (6) , Angélique Guillaudeau (5) , Laura Mesturoux (5) , Béma Coulibaly (5) , Christophe Lautrette (1) , Muriel Mathonnet (8, 6)

1 ONCOMEDICS SAS
2 CIC1435 - Centre d'Investigation Clinique de Limoges
3 NET - Neuroépidémiologie Tropicale
4 SIME - Service de l'Information Médicale et de l'Évaluation [CHU Limoges]
5 Service d'Anatomie Pathologique [CHU Limoges]
6 Service de Chirurgie digestive, endocrinienne et générale [CHU Limoges]
7 Service d'Oncologie médicale [CHU Limoges]
8 HCP - Homéostasie Cellulaire et Pathologies

Background: colorectal cancer (CRC) remains a major public concern. While conventional chemotherapeutic regimens have proved useful against advanced/metastatic diseases, progresses are to be made to effectively cure the large portion of patients not benefiting from these treatments. One direction to improve response rates is to develop chemosensitivity and resistance assays (CSRAs) efficiently assisting clinicians in treatment selection process, an already long preoccupation of oncologists and researchers. Several methods have been described to this day, none achieving yet sufficient reliability for recommended use in the clinical routine. Methods: We led a pilot study on 19 metastatic CRC patients evaluating capacity of the Oncogramme, a standardized process using tumor ex vivo models, to provide chemosensitivity profiles and predict clinical outcome of patients receiving standard CRC chemotherapeutics. Oncogramme responses were categorized according to the method of percentiles to assess sensitivity, specificity and concordance. Results: We report from a primary analysis a success rate of 97.4 %, a very good sensitivity (84.6 %), a below-average specificity (33.3 %), along with a global agreement of 63.6 % and a concordance between Oncogramme results and patients’ responses (Kappa coefficient) of 0.193. A supplementary analysis, focusing on CRC patients with no treatment switch over a longer time course, demonstrated improvement in specificity and concordance. Conclusions: Results establish feasibility and usefulness of the Oncogramme, prelude to a larger-scale trial. Advantages and drawbacks of the procedure are discussed, as well as the place of CSRAs within the future arsenal of methods available to clinicians to individualize treatments and improve patient prognosis.

Mots clés: Chemosensitivity and resistance assay; Primary culture; Individualized tumor response testing; Ex vivo model; Colorectal cancer; Oncogramme

Domaines: Cancer; Santé publique et épidémiologie

Christophe Bounaix Morand Du Puch, Michelle Nouaille, Stéphanie Giraud, Anaïs Labrunie, Sandrine Luce, et al.. Chemotherapy outcome predictive effectiveness by the Oncogramme: pilot trial on stage-IV colorectal cancer. Journal of Translational Medicine, 2016, 14 (1), pp.10. ⟨10.1186/s12967-016-0765-4⟩. ⟨hal-01497055⟩