We assessed the impact on survival of angiogenesis and inflammation-related factors, particularly LDH serum levels, platelet, neutrophil and lymphocyte counts, and neutrophil-to-lymphocyte ratio (NLR), in metastatic colorectal cancer patients receiving regorafenib monotherapy

Aprile, G

Bianconi, M

Bittoni, A

Cascinu, S

Del Prete, M

Falcone, A

Faloppi, L

Giampieri, R

Loupakis, F

Prochilo, T

Salvatore, L

Scartozzi, M

Zaniboni, A

PubMed

BACKGROUND:

We assessed the impact on survival of angiogenesis and inflammation-related factors, particularly LDH serum levels, platelet, neutrophil and lymphocyte counts, and neutrophil-to-lymphocyte ratio (NLR), in metastatic colorectal cancer patients receiving regorafenib monotherapy.
METHODS:

LDH serum levels, neutrophil, lymphocyte and platelet counts were collected at the start of regorafenib monotherapy. Cut-off values were calculated by ROC curve analysis. Survival analyses were performed by Kaplan-Meier method, and multivariate analysis by Cox method.
RESULTS:

A total of 208 patients were eligible for analysis. Among factors who were related with worse overall survival and who maintained their role at the multivariate analysis, high platelet count (Exp(b):1.4963, 95% CI:1.0130-2.2103, p = 0.0439) and high neutrophil/lymphocyte ratio (Exp(b):1.6963, 95% CI:1.0757-2.6751, p = 0.0237) were those who more deeply were related to worse overall survival. High lymphocyte count (Exp(b):0.4527, 95% CI:0.2801-0.7316, p = 0.0013) was correlated with improved overall survival.
CONCLUSIONS:

High neutrophil, high platelet, low lymphocyte count and/or high NLR may represent negative prognostic factors in patients receiving regorafenib monotherapy. It is advisable that these factors are taken into account in the design of subsequent trials in colorectal cancer patients receiving this drug

DEL PRETE, MICHELA

GIAMPIERI, RICCARDO

FALOPPI, LUCA

BIANCONI, MARISTELLA

BITTONI, ALESSANDRO

SCARTOZZI, MARIO

CASCINU, Stefano

Loupakis, Fotios

Prochilo, Tiziana

Salvatore, Lisa

Aprile, Giuseppe

Zaniboni, Alberto

Falcone, Alfredo

IRIS UniversitÃ  Politecnica delle Marche

Prognostic clinical factors in pretreated colorectal cancer patients receiving regorafenib: Implications for clinical management

Michela Del Prete

Riccardo Giampieri

Fotios Loupakis

Tiziana Prochilo

Lisa Salvatore

Luca Faloppi

Maristella Bianconi

Alessandro Bittoni

Giuseppe Aprile

Alberto Zaniboni

Alfredo Falcone

Mario Scartozzi

Stefano Cascinu

Crossref

Oncotarget

 591  Background: Most of the patients receiving regorafenib do not seem to benefit from this treatment approach and are therefore exposed to unnecessary toxicity. Angiogenesis and inflammation-related factors may have a relevant role in modulating the activity of anti-angiogenetic drugs such as regorafenib. In our study, we investigated LDH serum levels, platelet, neutrophil, and lymphocyte counts, and neutrophil-to-lymphocyte ratio (NLR) in predicting clinical outcomes for colorectal cancer patients receiving regorafenib. The final aim was to individuate an easy to use and reliable selection tool for these patients in the clinical practice. Methods: We collected LDH serum levels, neutrophil, lymphocyte, and platelet counts within one month before the start of regorafenib in 208 pretreated metastatic colorectal cancer patients. Cut-off values were calculated by ROC curve analysis. Survival analysis was performed by Kaplan-Meier method, and multivariate analysis by Cox method. Results: At multivariate analysis: high platelet count (p=0.0439), low lymphocyte count (p=0.0013), and high NLR (p=0.0237) were related to worse overall survival (OS); high neutrophil count and high NLR (p=0.0058) were related to worse progression free survival (PFS). Among 52 (25%) patients who were negative for all risk factors, a significant correlation was found with improved OS and PFS if compared with the group of patients with at least one risk factor. In particular, median OS was respectively 15.9 vs. 3.1 months (HR: 3.81, 95% CI: 2.32-4.82, p&lt;0.0001) whereas median PFS was 5.9 vs. 2.1 months (HR: 2.62, 95% CI: 2.06-3.86, p&lt;0.0001). Conclusions: We can speculate that colorectal cancer patients showing high neutrophil, high platelet, low lymphocyte count or high NLR may not be optimal candidates for regorafenib treatment. After confirmation in further prospective series, these clinical factors could play a role in the treatment strategy process. </jats:p

Journal of Clinical Oncology

Prognostic clinical factors in pretreated colorectal cancer patients receiving regorafenib: Implications for clinical management.

Cascinu, S.

Archivio istituzionale della ricerca - Università di Cagliari

Prognostic clinical factors in pretreated colorectal cancer patients receiving regorafenib: implications for clinical management

http://creativecommons.org/licenses/by/2.5/

Prognostic clinical factors in pretreated colorectal cancer patients receiving regorafenib: implications for clinical management

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IRIS UniversitÃ Politecnica delle Marche

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Archivio istituzionale della ricerca - Università di Cagliari