title: Impact of Serum Apolipoprotein A-I on Prognosis and Bevacizumab Efficacy in Patients with Metastatic Colorectal Cancer: a Propensity Score-Matched Analysis.
abstract: OBJECTIVE
  We aimed to investigate the role of apolipoprotein A-I (ApoA-I) as a predictor of prognosis and treatment efficacy of bevacizumab in patients with metastatic colorectal cancer (mCRC) treated with first-line chemotherapy with or without bevacizumab.
  
  
  METHODS
  We conducted a retrospective study on consecutive patients who were diagnosed with mCRC at Sun Yat-sen University Cancer Center. According to their pretreatment ApoA-I level, patients were divided into low- and high-ApoA-I groups. Propensity score-matched method was performed to balance baseline characteristics between two groups. Based on whether they accepted bevacizumab as a first-line therapy, patients were further divided into the chemo + bevacizumab group and the chemo group. Overall survival (OS) and progression-free survival (PFS) were assessed with Kaplan-Meier method, log-rank test, and Cox regression.
  
  
  RESULTS
  The optimal cutoff value for the ApoA-I level was determined to be 1.105 g/l. In the propensity-matched cohort of 508 patients, low ApoA-I was significantly associated with inferior OS (P<.001) and PFS (P<.001) than high ApoA-I. Multivariate analysis showed that ApoA-I level was an independent prognostic maker of OS (P<.001) and PFS (P=.001). PFS (P<.001) in either the high- or low-ApoA-I groups could be extended significantly after the administration of bevacizumab, and patients with a high ApoA-I level also had a better OS in the chemo + bevacizumab group than the chemo group (P=.049).
  
  
  CONCLUSIONS
  Patients with a low ApoA-I level have poor prognoses, and they did not display an OS benefit from bevacizumab.
authors.affiliation: State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China; VIP Region, Sun Yat-Sen University Cancer Center, Guangzhou, China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Quan
authors.affiliation: State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China; VIP Region, Sun Yat-Sen University Cancer Center, Guangzhou, China.
authors.forename: Yuanyuan
authors.initials: Y
authors.lastname: Huang
authors.affiliation: Department of Oncology, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Chen
authors.affiliation: State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China; VIP Region, Sun Yat-Sen University Cancer Center, Guangzhou, China.
authors.forename: Huijuan
authors.initials: H
authors.lastname: Qiu
authors.affiliation: State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China; VIP Region, Sun Yat-Sen University Cancer Center, Guangzhou, China.
authors.forename: Qiaozhen
authors.initials: Q
authors.lastname: Hu
authors.affiliation: State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China; VIP Region, Sun Yat-Sen University Cancer Center, Guangzhou, China.
authors.forename: Yuming
authors.initials: Y
authors.lastname: Rong
authors.affiliation: State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China; VIP Region, Sun Yat-Sen University Cancer Center, Guangzhou, China.
authors.forename: Tingwei
authors.initials: T
authors.lastname: Li
authors.affiliation: State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China; VIP Region, Sun Yat-Sen University Cancer Center, Guangzhou, China.
authors.forename: Liangping
authors.initials: L
authors.lastname: Xia
authors.affiliation: State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China; VIP Region, Sun Yat-Sen University Cancer Center, Guangzhou, China. Electronic address: zhangbeisysucc@126.com.
authors.forename: Bei
authors.initials: B
authors.lastname: Zhang