Neutropenia as a Predictive Factor in Metastatic Colorectal Cancer Treated With TAS-102
Neutropenia as a Predictive Factor in Metastatic Colorectal Cancer Treated With TAS-102
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DOI：
10.1016/j.clcc.2016.07.005
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发表时间：
2017-03-01
影响因子：
3.4
通讯作者：
Taniguchi, Hiroya
中科院分区：
文献类型：
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作者：
Hamauchi, Satoshi;Yamazaki, Kentaro;Taniguchi, Hiroya
TAS-102单药治疗结直肠癌最常见的治疗相关不良事件是骨髓抑制，导致中性粒细胞减少。对2家机构的95例患者进行了一项回顾性研究，以评价疗效与中性粒细胞减少之间的相关性。我们的研究结果表明，TAS-102引起的中性粒细胞减少与更好的疗效相关。背景：TAS-102可显著提高转移性结直肠癌患者的总生存率。TAS-102最常见的治疗相关不良事件是骨髓抑制，导致中性粒细胞减少。细胞毒性药物引起的中性粒细胞减少症的潜在预测价值已在各种类型的癌症中报道。研究方法：我们回顾性分析了2014年5月至2015年5月期间在2家日本机构接受TAS 102治疗的95例连续转移性结直肠癌患者。为了评价疗效与中性粒细胞减少之间的相关性，根据TAS-102第一个周期内的中性粒细胞减少等级将患者分为4类：A类（0-1级）、B类（2-4级）、C类（0-2级）和D类（3-4级）。结果如下：患者特征如下：中位年龄，64岁;男性，58%;东部肿瘤协作组体能状态0至1，91%;原发部位结肠，49%; KRAS外显子2野生型，57%;转移部位数量≥ 3，55%。疾病控制率在A类和B类之间（29.2% vs. 52.6%; P = 0.045）以及在C类和D类之间（30.9% vs. 72.2%; P = 0.002）存在显著差异。在多变量分析中，与C类相比，D类仍然是无进展生存期的重要预测因素（4.3 vs. 2.0个月;风险比，0.45; P =.01）。结论：TAS-102在第一周期引起的中性粒细胞减少与更好的疗效相关。中性粒细胞增多症可能是TAS-102足够抗肿瘤剂量的替代标志物。(C)2016 Elsevier Inc. All rights reserved.
The most common treatment-related adverse event of TAS-102 monotherapy for colorectal cancer is bone marrow suppression, which leads to neutropenia. A retrospective study of 95 patients at 2 institutions was performed to evaluate the association between efficacy and neutropenia. Our findings indicate that neutropenia caused by TAS-102 was associated with better efficacy.Background: TAS-102 significantly improves overall survival in patients with metastatic colorectal cancer. The most common treatment-related adverse event of TAS-102 is bone marrow suppression, which leads to neutropenia. The potential predictive value of neutropenia caused by cytotoxic drugs has been reported in various types of cancer. Methods: We retrospectively analyzed 95 consecutive patients with metastatic colorectal cancer who received TAS102 at 2 Japanese institutions between May 2014 and May 2015. To evaluate the association between efficacy and neutropenia, patients were divided into 4 categories according to the grade of neutropenia during the first cycle of TAS-102: Category A (grade 0-1), B (grade 2-4), C (grade 0-2), and D (grade 3-4). Results: Patient characteristics were as follows: median age, 64 years; male, 58%; Eastern Cooperative Oncology Group performance status 0 to 1, 91%; primary site colon, 49%; KRAS exon 2 wild, 57%; and number of metastatic site >= 3, 55%. The disease control rate was significantly different between Category A and B (29.2% vs. 52.6%; P =.045) and between Category C and D (30.9% vs. 72.2%; P =.002). In multivariate analysis, Category D remained a significant predictive factor for progression-free survival compared with Category C (4.3 vs. 2.0 months; hazard ratio, 0.45; P =.01). Conclusion: Neutropenia caused by TAS-102 during the first cycle was associated with better efficacy. Neutropenia may be a surrogate marker for adequate antitumor doses of TAS-102. (C) 2016 Elsevier Inc. All rights reserved.