Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Riedl, J.
Inflammatory biomarkers in metastatic colorectal cancer: Prognostic and predictive role beyond the first line setting
Humanmedizin; [ Diplomarbeit ] Graz Medical University; 2018. pp.
[OPEN ACCESS]
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Gerger Armin
- Posch Florian
- Stotz Michael
- Altmetrics:
- Abstract:
- Introduction Inflammation based biomarkers are useful prognostic tools in cancer patients. However, the prognostic and predictive value of inflammatory biomarkers beyond the first line setting in metastatic colorectal cancer has not been investigated yet. In this study we aim to quantify the significance of the neutrophil/lymphocyte ratio (NLR), the lymphocyte/monocyte ratio (LMR), the platelet/lymphocyte ratio (PLR), the C-reactive protein (CRP) level and the advanced lung cancer inflammation index (ALI) as prognostic markers for therapy response and disease outcome over the first three treatment lines in metastatic colorectal cancer (mCRC) patients. Materials and Methods Two-hundred-fifty-eight patients with mCRC undergoing palliative chemo(immuno-)therapy were included in this retrospective study. The primary endpoints were 6-month PFS and ORR during 1st-line, 2nd-line, and 3rd-line treatment, and 6-month overall survival during BSC. Results In multivariable analysis adjusting for polychemotherapy, 1 standard deviation increase in NLR was associated with an 8.5% absolute lower objective response rate (ORR) in first line (11-7, p<0.0001), 3% lower ORR in second line (4-2, p< 0.0001), and 3% lower ORR in third line (8-2, p=0.24), respectively. Regarding progression free survival (PFS), an increase in the NLR was significantly associated with rising hazard ratios (HR) of progression over all treatment lines (HR 1.30, p= 0.021 first line); (HR 1.37, p<0.0001 second line); (HR 1.44, p=0.042 third line). The PLR was associated with 6-month PFS over all lines. (HR 1.43 (95%CI 1.09–1.88, p= 0.009 first line); HR 1.67 (95%CI 1.34–2.09, p< 0.0001 second line) and HR 1.43 (95%CI 1.04–1.98, p=0.029 in third line)) For CRP, the prognostic association was significant in the first two chemotherapy lines and in case of best supportive care (BSC). (HR 1.49 (95%CI 1.23–1.80, p<0.0001 first line); HR 1.25 (95%CI 1.06–1.47, p=0.007 second line); HR 1.09 (95%CI 0.81–1.48, p=0.552 third line and HR 1.43 (1.15–1.79, p= 0.002 in BSC)) Conclusion Our data suggest that inflammatory biomarkers are useful predictors for disease outcome and treatment response over several treatment lines and best supportive care in mCRC patients.