title: Interleukin-6 and C-reactive protein as prognostic biomarkers in metastatic colorectal cancer.
abstract: OBJECTIVE
  The aim was to explore the prognostic significance of IL-6 and markers of systemic inflammatory response (SIR), in particular C-reactive protein (CRP), in metastatic colorectal cancer (mCRC) patients, in the total study population and according to RAS and BRAF mutation status.
  
  
  RESULTS
  High levels of pretreatment serum IL-6 or CRP were associated with impaired outcome, in terms of reduced PFS and OS. Patients with low versus high serum IL-6 levels had median OS of 26.0 versus 16.6 months, respectively (P < 0.001). Stratified according to increasing CRP levels, median OS varied from 24.3 months to 12.3 months, (P < 0.001). IL-6 and CRP levels affected overall prognosis also in adjusted analyses. The effect of IL-6 was particularly pronounced in patients with BRAF mutation (interaction P = 0.004).
  
  
  METHODS
  IL-6 and CRP were determined in pre-treatment serum samples from 393 patients included in the NORDIC-VII trial, in which patients with mCRC received first line treatment. The effect of serum IL-6 and CRP on progression-free survival (PFS) and overall survival (OS) was estimated.
  
  
  CONCLUSIONS
  High baseline serum consentrations of IL-6 or CRP were associated with impaired prognosis in mCRC. IL-6 and CRP give independent prognostic information in addition to RAS and BRAF mutation status.
authors.affiliation: Department of Oncology, Oslo University Hospital, Oslo, Norway.|Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
authors.forename: Maria
authors.initials: M
authors.lastname: Thomsen
authors.affiliation: Department of Oncology, Southern Hospital Trust, Kristiansand, Norway.
authors.forename: Christian
authors.initials: C
authors.lastname: Kersten
authors.affiliation: Department of Oncology, Haukeland University Hospital, University of Bergen, Bergen, Norway.
authors.forename: Halfdan
authors.initials: H
authors.lastname: Sorbye
authors.affiliation: Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Eva
authors.initials: E
authors.lastname: Skovlund
authors.affiliation: Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden.
authors.forename: Bengt
authors.initials: B
authors.lastname: Glimelius
authors.affiliation: Department of Oncology, Odense University Hospital, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.
authors.forename: Per
authors.initials: P
authors.lastname: Pfeiffer
authors.affiliation: Department of Oncology, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark.
authors.forename: Julia S
authors.initials: JS
authors.lastname: Johansen
authors.affiliation: Department of Cancer Genetics, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway.
authors.forename: Elin H
authors.initials: EH
authors.lastname: Kure
authors.affiliation: Akershus University Hospital, Nordbyhagen, Norway.
authors.forename: Tone
authors.initials: T
authors.lastname: Ikdahl
authors.affiliation: Department of Oncology, Oslo University Hospital, Oslo, Norway.|Institute of Clinical Medicine, University of Oslo, Oslo, Norway.|K.G. Jebsen Colorectal Cancer Research Centre, Oslo University Hospital, Oslo, Norway.
authors.forename: Kjell Magne
authors.initials: KM
authors.lastname: Tveit
authors.affiliation: Department of Pharmacology, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
authors.forename: Thoralf
authors.initials: T
authors.lastname: Christoffersen
authors.affiliation: Department of Oncology, Oslo University Hospital, Oslo, Norway.|K.G. Jebsen Colorectal Cancer Research Centre, Oslo University Hospital, Oslo, Norway.
authors.forename: Tormod Kyrre
authors.initials: TK
authors.lastname: Guren
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor; D002097:C-Reactive Protein; D015179:Colorectal Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D011905:Genes, ras; D006801:Humans; D018836:Inflammation Mediators; D015850:Interleukin-6 / Q000097:blood*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009154:Mutation; D009362:Neoplasm Metastasis; D011379:Prognosis; D048493:Proto-Oncogene Proteins B-raf / Q000235:genetics; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D018836:Inflammation Mediators; D015850:Interleukin-6; D002097:C-Reactive Protein; D048493:Proto-Oncogene Proteins B-raf
keywords: CRP; IL-6; mCRC; prognostic biomarker; survival