Inflammatory indexes as predictors of prognosis and bevacizumab efficacy in patients with metastatic colorectal cancer.
BACKGROUND
To investigate the role of pre-treatment inflammatory indexes (II) as predictors of prognosis and treatment efficacy in patients with metastatic colorectal cancer mCRC randomized onto the prospective multicenter randomized ITACa (Italian Trial in Advanced Colorectal Cancer) trial to receive first-line chemotherapy (CT) with or without bevacizumab (Bev).


RESULTS
In the overall population, PFS and OS were higher in patients with low SII (p = .015 and .002, respectively), low NLR (p = .0001 and <.0001, respectively) and low PLR (p = .004 and .008, respectively). Patients with low NLR in the CT plus Bev arm had a higher PFS than those treated with CT alone (HR = 0.69, p = .021).


METHODS
Two hundred and eighty-nine patients were considered for this study, 141 receiving CT plus Bev and 148 receiving CT alone. The pre-treatment systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) were evaluated to identify a potential correlation with progression-free (PFS) and overall survival (OS) in both the overall population and the 2 treatment arms.


CONCLUSIONS
Our results indicate that II, in particular NLR, are good prognostic and predictive markers for mCRC patients who are candidates for CT plus Bev.
Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy.
Alessandro
A
Passardi
Unit of Biostatistics and Clinical Trials, IRST IRCCS, Meldola, Italy.
Emanuela
E
Scarpi
Medical Oncology Unit, Guglielmo da Saliceto Hospital, Piacenza, Italy.
Luigi
L
Cavanna
Unit of Biostatistics and Clinical Trials, IRST IRCCS, Meldola, Italy.
Monia
M
Dall'Agata
Department of Oncology, Infermi Hospital, Rimini, Italy.
Davide
D
Tassinari
Medical Oncology Unit, Vito Fazzi Hospital, Lecce, Italy.
Silvana
S
Leo
Medical Oncology Unit, Ramazzini Hospital, Carpi, Italy.
Ilaria
I
Bernardini
Oncology Unit, University Hospital Modena, Modena, Italy.
Fabio
F
Gelsomino
Oncology Unit, Degli Infermi Hospital, Faenza, Italy.
Stefano
S
Tamberi
Department of Medical Oncology, Azienda USL, Bellaria Hospital - IRCCS Institute of Neurological Sciences, Bologna, Italy.
Alba A
AA
Brandes
Oncology Pharmacy Laboratory, IRST IRCCS, Meldola, Italy.
Elena
E
Tenti
IT Service, IRST IRCCS, Meldola, Italy.
Roberto
R
Vespignani
Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy.
Giovanni L
GL
Frassineti
Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy.
Dino
D
Amadori
Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy.
Ugo
U
De Giorgi
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D000068258:Bevacizumab / Q000009:adverse effects / Q000627:therapeutic use*; D001792:Blood Platelets; D015179:Colorectal Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007558:Italy; D053208:Kaplan-Meier Estimate; D018655:Lymphocyte Count; D008214:Lymphocytes; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009504:Neutrophils; D018579:Patient Selection; D010976:Platelet Count; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome
D000068258:Bevacizumab
SII NLR PLR; bevacizumab; metastatic colorectal cancer; prognosis