Research Papers:

Inflammatory indexes as predictors of prognosis and bevacizumab efficacy in patients with metastatic colorectal cancer

Alessandro Passardi _, Emanuela Scarpi, Luigi Cavanna, Monia Dall’Agata, Davide Tassinari, Silvana Leo, Ilaria Bernardini, Fabio Gelsomino, Stefano Tamberi, Alba A. Brandes, Elena Tenti, Roberto Vespignani, Giovanni L. Frassineti, Dino Amadori and Ugo De Giorgi

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Oncotarget. 2016; 7:33210-33219. https://doi.org/10.18632/oncotarget.8901

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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


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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