Research Papers:

Prognostic role of serum concentrations of high-sensitivity C-reactive protein in patients with metastatic colorectal cancer: results from the ITACa trial

Andrea Casadei Gardini _, Silvia Carloni, Emanuela Scarpi, Paolo Maltoni, Romolo M. Dorizzi, Alessandro Passardi, Giovanni Luca Frassineti, Pietro Cortesi, Maria Benedetta Giannini, Giorgia Marisi, Dino Amadori and Alessandro Lucchesi

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Oncotarget. 2016; 7:10193-10202. https://doi.org/10.18632/oncotarget.7166

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Andrea Casadei Gardini1,*, Silvia Carloni2,*, Emanuela Scarpi3, Paolo Maltoni4, Romolo M. Dorizzi4, Alessandro Passardi1, Giovanni Luca Frassineti1, Pietro Cortesi1, Maria Benedetta Giannini1, Giorgia Marisi2, Dino Amadori1, Alessandro Lucchesi1

1Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy

2Biosciences Laboratory, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy

3Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy

4Corelab Unit, AVR Laboratory, Cesena, Italy

*These authors contributed equally to this work

Correspondence to:

Andrea Casadei Gardini, e-mail: [email protected]

Keywords: metastatic colorectal cancer, high-sensitivity C-reactive protein, thrombosis, progression-free survival, overall survival

Received: October 15, 2015     Accepted: January 24, 2016     Published: February 03, 2016


Serum levels of C-reactive protein are (CRP) higher in patients with neoplastic conditions and numerous studies have been performed to clarify the etiologic and prognostic role of the high-sensitivity CRP (hs-CRP) in cancer. Our study was conducted on patients enrolled in the prospective randomized “Italian Trial in Advanced Colorectal Cancer (ITACa)” to assess hs-CRP levels and their impact on overall survival (OS) and progression-free survival (PFS). Serum samples from 132 ITACa patients were collected at baseline and 2 months after starting first-line chemotherapy. The supernatant was immediately transferred to cryovials and stored at –80°C. After thawing, hs-CRP was measured with the Cobas c501 analyzer. High levels of hs-CRP (≥ 13.1 mg/L) were associated with poorer median PFS (p < 0.0001) and OS (p < 0.0001) than low hs-CRP levels (< 13.1 mg/L). hs-CRP values in 107 patients were evaluated again after 2 months of therapy, revealing that patients with low hs-CRP levels in both baseline and second serum samples had the best median PFS and OS. Our study confirms the prognostic value of hs-CRP in patients with metastatic colorectal carcinoma.

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