Clinical Research Papers:
Prognostic clinical factors in pretreated colorectal cancer patients receiving regorafenib: implications for clinical management.
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Michela Del Prete1, Riccardo Giampieri1, Fotios Loupakis3, Tiziana Prochilo2, Lisa Salvatore3, Luca Faloppi1, Maristella Bianconi1, Alessandro Bittoni1, Giuseppe Aprile4, Alberto Zaniboni2, Alfredo Falcone3, Mario Scartozzi5, Stefano Cascinu1
1Medical Oncology, AO Ospedali Riuniti-Università Politecnica delle Marche, 60126 Ancona, Italy
2Medical Oncology, Fondazione Poliambulanza, 25124 Brescia, Italy
3Medical Oncology, Azienda Ospedaliero-Universitaria Pisana, 56126 Pisa, Italy
4Medical Oncology, Azienda Ospedaliero-Universitaria “S. Maria della Misericordia”, 33100 Udine, Italy
5Medical Oncology, Azienda Ospedaliero-Universitaria di Cagliari, 09042 Monserrato (CA), Cagliari, Italy
Mario Scartozzi, e-mail: [email protected]
Keywords: regorafenib, colorectal cancer, prognostic factors, LDH, neutrophil/lymphocyte ratio
Received: June 26, 2015 Accepted: August 04, 2015 Published: August 17, 2015
Background: We assessed the impact on survival of angiogenesis and inflammation-related factors, particularly LDH serum levels, platelet, neutrophil and lymphocyte counts, and neutrophil-to-lymphocyte ratio (NLR), in metastatic colorectal cancer patients receiving regorafenib monotherapy.
Methods: LDH serum levels, neutrophil, lymphocyte and platelet counts were collected at the start of regorafenib monotherapy. Cut-off values were calculated by ROC curve analysis. Survival analyses were performed by Kaplan-Meier method, and multivariate analysis by Cox method.
Results: A total of 208 patients were eligible for analysis. Among factors who were related with worse overall survival and who maintained their role at the multivariate analysis, high platelet count (Exp(b):1.4963, 95% CI:1.0130–2.2103, p = 0.0439) and high neutrophil/lymphocyte ratio (Exp(b):1.6963, 95% CI:1.0757–2.6751, p = 0.0237) were those who more deeply were related to worse overall survival. High lymphocyte count (Exp(b):0.4527, 95% CI:0.2801–0.7316, p = 0.0013) was correlated with improved overall survival.
Conclusions: High neutrophil, high platelet, low lymphocyte count and/or high NLR may represent negative prognostic factors in patients receiving regorafenib monotherapy. It is advisable that these factors are taken into account in the design of subsequent trials in colorectal cancer patients receiving this drug.
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