Revised Tumor Burden Score for Prognostic Stratification in Metastatic Colorectal Cancer Patients Receiving Immunotherapy: A Retrospective Study. (PubMed, Oncologist)
The revised tumor burden score (rTBS) provides a clinically actionable, cost-effective tool to enhance prognostic stratification in patients with metastatic colorectal cancer (mCRC) receiving immunotherapy. By integrating routinely available metrics (CEA, metastatic organ count, and target lesions), rTBS achieves superior prognostic discrimination (AUC = 0.768) compared to traditional biomarkers such as TMB (AUC = 0.656) and consistently stratifies outcomes across molecular subtypes. Of particular clinical relevance, rTBS identifies patients with more favorable prognosis within the MSI-L/MSS/TMB-Low subgroup, addressing a major unmet need in this biomarker-limited population. It also refines risk stratification in MSI-H/TMB-High patients by identifying those with high tumor burden and poor prognosis. By leveraging readily accessible clinical and imaging data, rTBS circumvents the need for costly molecular profiling, bringing pragmatic risk stratification within reach even in resource-constrained settings. These findings position rTBS as a useful decision-support tool for prognostic evaluation, assisting clinicians in personalizing management strategies for mCRC.