Research Papers:
Inflammatory indexes as predictors of prognosis and bevacizumab efficacy in patients with metastatic colorectal cancer
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Abstract
Alessandro Passardi1,*, Emanuela Scarpi2,*, Luigi Cavanna3, Monia Dall’Agata2, Davide Tassinari4, Silvana Leo5, Ilaria Bernardini6, Fabio Gelsomino7, Stefano Tamberi8, Alba A. Brandes9, Elena Tenti10, Roberto Vespignani11, Giovanni L. Frassineti1, Dino Amadori1, Ugo De Giorgi1
1Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
2Unit of Biostatistics and Clinical Trials, IRST IRCCS, Meldola, Italy
3Medical Oncology Unit, Guglielmo da Saliceto Hospital, Piacenza, Italy
4Department of Oncology, Infermi Hospital, Rimini, Italy
5Medical Oncology Unit, Vito Fazzi Hospital, Lecce, Italy
6Medical Oncology Unit, Ramazzini Hospital, Carpi, Italy
7Oncology Unit, University Hospital Modena, Modena, Italy
8Oncology Unit, Degli Infermi Hospital, Faenza, Italy
9Department of Medical Oncology, Azienda USL, Bellaria Hospital - IRCCS Institute of Neurological Sciences, Bologna, Italy
10Oncology Pharmacy Laboratory, IRST IRCCS, Meldola, Italy
11IT Service, IRST IRCCS, Meldola, Italy
*These authors have contributed equally to this work
Correspondence to:
Emanuela Scarpi, e-mail: [email protected]
Keywords: metastatic colorectal cancer, bevacizumab, SII NLR PLR, prognosis
Received: February 24, 2016 Accepted: April 04, 2016 Published: April 21, 2016
ABSTRACT
Background: To investigate the role of pre-treatment inflammatory indexes (II) as predictors of prognosis and treatment efficacy in patients with metastatic colorectal cancer mCRC randomized onto the prospective multicenter randomized ITACa (Italian Trial in Advanced Colorectal Cancer) trial to receive first-line chemotherapy (CT) with or without bevacizumab (Bev).
Results: In the overall population, PFS and OS were higher in patients with low SII (p = .015 and .002, respectively), low NLR (p = .0001 and <.0001, respectively) and low PLR (p = .004 and .008, respectively). Patients with low NLR in the CT plus Bev arm had a higher PFS than those treated with CT alone (HR = 0.69, p = .021).
Patients and Methods: Two hundred and eighty-nine patients were considered for this study, 141 receiving CT plus Bev and 148 receiving CT alone. The pre-treatment systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) were evaluated to identify a potential correlation with progression-free (PFS) and overall survival (OS) in both the overall population and the 2 treatment arms.
Conclusion: Our results indicate that II, in particular NLR, are good prognostic and predictive markers for mCRC patients who are candidates for CT plus Bev.
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