Prognostic clinical factors in pretreated colorectal cancer patients receiving regorafenib: implications for clinical management.
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.
Medical Oncology, AO Ospedali Riuniti-Università Politecnica delle Marche, Ancona, Italy.
Michela
M
Del Prete
Medical Oncology, AO Ospedali Riuniti-Università Politecnica delle Marche, Ancona, Italy.
Riccardo
R
Giampieri
Medical Oncology, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
Fotios
F
Loupakis
Medical Oncology, Fondazione Poliambulanza, Brescia, Italy.
Tiziana
T
Prochilo
Medical Oncology, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
Lisa
L
Salvatore
Medical Oncology, AO Ospedali Riuniti-Università Politecnica delle Marche, Ancona, Italy.
Luca
L
Faloppi
Medical Oncology, AO Ospedali Riuniti-Università Politecnica delle Marche, Ancona, Italy.
Maristella
M
Bianconi
Medical Oncology, AO Ospedali Riuniti-Università Politecnica delle Marche, Ancona, Italy.
Alessandro
A
Bittoni
Medical Oncology, Azienda Ospedaliero-Universitaria "S. Maria della Misericordia", Udine, Italy.
Giuseppe
G
Aprile
Medical Oncology, Fondazione Poliambulanza, Brescia, Italy.
Alberto
A
Zaniboni
Medical Oncology, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
Alfredo
A
Falcone
Medical Oncology, Azienda Ospedaliero-Universitaria di Cagliari, Monserrato, Cagliari, Italy.
Mario
M
Scartozzi
Medical Oncology, AO Ospedali Riuniti-Università Politecnica delle Marche, Ancona, Italy.
Stefano
S
Cascinu
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001792:Blood Platelets / Q000166:cytology; D015179:Colorectal Neoplasms / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000188:drug therapy; D053208:Kaplan-Meier Estimate; D007770:L-Lactate Dehydrogenase / Q000097:blood; D018655:Lymphocyte Count; D008214:Lymphocytes / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009362:Neoplasm Metastasis; D009389:Neovascularization, Pathologic; D009504:Neutrophils / Q000166:cytology; D010671:Phenylurea Compounds / Q000627:therapeutic use*; D011379:Prognosis; D016016:Proportional Hazards Models; D011725:Pyridines / Q000627:therapeutic use*; D012372:ROC Curve; D012189:Retrospective Studies; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D010671:Phenylurea Compounds; D011725:Pyridines; C559147:regorafenib; D007770:L-Lactate Dehydrogenase
LDH; colorectal cancer; neutrophil/lymphocyte ratio; prognostic factors; regorafenib