Validation of Neutrophil Count as An Algorithm-Based Predictive Factor of Progression-Free Survival in Patients with Metastatic Soft Tissue Sarcomas Treated with Trabectedin
Validation of Neutrophil Count as An Algorithm-Based Predictive Factor of Progression-Free Survival in Patients with Metastatic Soft Tissue Sarcomas Treated with Trabectedin
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DOI：
10.3390/cancers11030432
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发表时间：
2019-03-01
期刊：
影响因子：
5.2
通讯作者：
Salas, Sebastien
中科院分区：
文献类型：
--
作者：
de Nonneville, Alexandre;Barbolosi, Dominique;Salas, Sebastien
简介：基于曲贝替定诱导的中性粒细胞减少症的数学模型，我们评估了绝对中性粒细胞计数（ANC）对接受曲贝替定治疗的患者的独立验证队列的无进展生存期（PFS）的预测价值。研究方法：我们收集了来自两个专家中心的87例患者的数据，这些患者接受了至少两个周期的曲贝替丁软组织肉瘤（STS）治疗。评估ANC、患者特征和生存率之间的相关性，并建立包括肿瘤分级、体力状态、ANC和血红蛋白水平的多变量模型。结果如下：治疗性ANC ≥ 7.5 G/L水平与较短的PFS相关：ANC ≥ 7.5 G/L患者为3.22个月（95%置信区间（CI），1.57-4.87），ANC < 7.5 G/L患者为5.78个月（95% CI，3.95-7.61）（p = 0.009）。年龄、原发部位、肺转移、剂量减少、血红蛋白和白蛋白率也与PFS相关。在多变量分析中，ANC >= 7.5 G/L与PFS和总生存率差独立相关。结论：我们验证了治疗前ANC增加是开始使用曲贝替定治疗STS的患者PFS短的预测因素。ANC似乎对生存率有影响，并可用作转移性STS患者个性化二线策略的决策工具。
Introduction: Based on a mathematical model of trabectedin-induced neutropenia, we assessed the predictive value of absolute neutrophil count (ANC) on progression-free survival (PFS) in an independent validation cohort of patients treated with trabectedin. Methods: We collected data from 87 patients in two expert centers who received at least two cycles of trabectedin for soft tissue sarcomas (STS) treatment. Correlations between ANC, patients' characteristics, and survival were assessed, and a multivariate model including tumor grade, performance status, ANC, and hemoglobin level was developed. Results: Therapeutic ANC >= 7.5 G/L level was associated with shorter PFS: 3.22 months (95% confidence interval (CI), 1.57-4.87) in patients with ANC >= 7.5 G/L vs. 5.78 months (95% CI, 3.95-7.61) in patients with ANC < 7.5 G/L (p = 0.009). Age, primary localization, lung metastases, dose reduction, hemoglobin, and albumin rates were also associated with PFS. In multivariate analysis, ANC >= 7.5 G/L was independently associated with poor PFS and overall survival. Conclusion: We validated increased pre-therapeutic ANC as a predictive factor of short PFS in patients starting trabectedin for STS. ANC appears to have an impact on survival rates and may be used as a decision-making tool for personalizing second-line strategies in patients with metastatic STS.