Inflammatory biomarkers in metastatic colorectal cancer: prognostic and predictive role beyond the first line setting.
Inflammatory biomarkers in metastatic colorectal cancer: prognostic and predictive role beyond the first line setting.
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DOI：
10.18632/oncotarget.21647
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发表时间：
2017-11-10
期刊：
影响因子：
--
通讯作者：
Gerger A
中科院分区：
文献类型：
--
作者：
Riedl JM;Posch F;Moik F;Bezan A;Szkandera J;Smolle MA;Kasparek AK;Pichler M;Stöger H;Stotz M;Gerger A
炎性生物标记物是预测癌症患者预后的有用工具。然而，转移性结直肠癌(MCRC)一线以外的炎性生物标志物的预后和预测价值尚不清楚。在多因素分析中，中性粒细胞淋巴细胞比率的标准差增加分别与一线(p<；0.0001)、二线(p<；0.0001)和三线(p<；0.0001)的绝对目标应答率降低8.5%、3%和3%相关。在无进展生存率(PFS)方面，NLR的增加与所有治疗路线的风险比(HR=1.3，p=0.021一线)显著相关(HR=1.37p<；0.0001二线)；(HR=1.44，p=0.042三线)。在所有三种治疗方案中，血小板淋巴细胞比率(PLR)与6个月的PFS相关。较高的C反应蛋白(CRP)预示着前两个化疗路线和最佳支持治疗(BSC)中PFS的恶化。(HR=1.49(p<；0.0001一线)；HR=1.25(p=0.007二线)；HR=1.09(95%可信区间0.81-1.48，p=0.552三线；HR=1.43(p=0.002，平衡计分卡))。对258例接受姑息化疗(免疫)治疗的多发性结直肠癌患者进行了回顾性研究。主要终点是一线、二线和三线治疗期间6个月的PFS和ORR，以及BSC期间6个月的总生存期。这项研究表明，炎性生物标记物在mCRC患者的几个治疗路线上是有用的疾病结局和治疗反应的预测因子。
Inflammatory biomarkers are useful prognostic tools in cancer patients. However, the prognostic and predictive value of inflammatory biomarkers beyond the 1st-line setting in metastatic colorectal cancer (mCRC) is unclear. In multivariate analysis 1 standard deviation increase in neutrophil-lymphocyte-ratio (NLR) was associated with an 8.5% absolute lower objective-response-rate (ORR) in 1st-line (p<0.0001), 3% lower ORR in 2nd-line (p< 0.0001), and 3% lower ORR in 3rd-line (p=0.24), respectively. Regarding progression free survival (PFS), an increase in the NLR was significantly associated with rising hazard-ratios (HR) over all treatment lines (HR=1.30, p= 0.021 1st-line); (HR=1.37, p<0.0001 2nd-line); (HR=1.44, p=0.042 3rd-line). The platelet-lymphocyte-ratio (PLR) was associated with 6-month PFS over all three treatment lines. Higher C-reactive-protein (CRP) predicted for worse PFS in the first two chemotherapy lines and in best supportive care (BSC). (HR=1.49 (p<0.0001 1st-line); HR=1.25 (p=0.007 2nd-line); HR=1.09 (95%CI 0.81–1.48, p=0.552 3rd-line and HR=1.43 (p= 0.002 in BSC)). Two-hundred-fifty-eight patients with mCRC undergoing palliative chemo(immuno-)therapy were retrospectively included. Primary endpoints were 6-month PFS and ORR during 1st-line, 2nd-line, and 3rd-line treatment, and 6-month overall survival during BSC. This study shows that inflammatory biomarkers are useful predictors of disease outcome and treatment response over several treatment lines in mCRC patients.
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