Abstract 1907
Background
dNLR (neutrophil count /(total white cell - neutrophil count)) has shown prognostic utility for overall survival (OS) in a number of cancers. The CCTG/AGITG CO.17 and CO.20 studies examined the EGFR inhibitor, cetuximab (C), versus best supportive care, and in combination with the VEGF/FGFR inhibitor brivanib (B) or placebo, respectively, in previously treated patients with mCRC. Here, we examine dNLR in CO.17 and CO.20 for its utility to predict progression free survival (PFS), response rate (RR) and OS.
Methods
Association between dNLR status and PFS, OS and RR was analysed using multivariate regression models adjusting for baseline (BL) disease and patient (pt) characteristics. Interaction between treatment and dNLR status was studied by including an additional interaction term in the models.
Results
CO.17 recruited 572 pts; 570 pts had available BL dNLR data. CO.20 recruited 750 pts; 718 had BL data available. In both, pts with high BL dNLR (≥2) were significantly more likely to have poorer ECOG status, received more lines of therapy, abnormal alkaline phosphatase levels, ≥ grade 1 anaemia, ascites, presented with lung metastases, have ≥2 sites of metastases. Multivariate analyses results are summarised in Table 1. Both studies showed pts with high dNLR had significantly shorter OS. Significant association of dNLR status with PFS was only found in CO.20 but no significant association with RR was found in either study. Significant association was found with OS in all four treatment groups, but for PFS, in C + B arm of CO.20 only. In both studies, no significant interaction was found between dNLR status and treatment for either OS or PFS.
Multivariate analysis of dNLR in CO.17 and CO.20
| CO.17 | CO.20 | |||
|---|---|---|---|---|
| dNLR | ConclusionsThe dNLR has independent prognostic utility for OS in previously treated patients with mCRC. This provides a simple, inexpensive prognostic biomarker for heavily pre-treated mCRC patients and should be considered as a stratification factor in future clinical trials. Clinical trial identificationClinicaltrials.gov CO.20: NCT00640471 CO.17: NCT00079066 Legal entity responsible for the studyCanadian Cancer Trials Group Australian Gastro-Intestinal Trials Group FundingCO.17: lead sponsor - Canadian Cancer Trials Group; co-sponsor - Australian Gastro-Intestinal Trials Group; funder - Bristol-Myers Squibb. CO.20: lead sponsor - Canadian Cancer Trials Group; co-sponsor - Australian Gastro-Intestinal Trials Group; funder - Bristol-Myers Squibb. DisclosureC.I. Diakos: Ipsen Aadvisory Board, November 2015 & April 2016. V. Gebski: Honoraria: Sirtex. Consultancy: Sirtex. Travel support: Sirtex. C.S. Karapetis: Advisory Board Merck, Amgen. N. Tebbutt: Advisory Board Roche, Merck Serono. L.L. Siu: Research funding from Bristol Myers Squibb for clinical trials conduct. T.J. Price: Advisory Board Merck. S. Clarke: Advisory Board Roche, Merck. All other authors have declared no conflicts of interest. Resources from the same session4162 - Efficacy of lanreotide autogel/depot (LAN) vs placebo (PBO) for symptomatic control of carcinoid syndrome (CS) in neuroendocrine tumor (NET) patients from the ELECT studyPresenter: Edward Wolin Session: Poster Display Resources: Abstract 3975 - Long-term safety/tolerability of lanreotide autogel/depot (LAN) treatment for metastatic intestinal and pancreatic neuroendocrine tumours (NETs): Final results of the CLARINET open-label extension (OLE)Presenter: Martyn Caplin Session: Poster Display Resources: Abstract 4163 - Longer term efficacy of lanreotide autogel/depot (LAN) for symptomatic treatment of carcinoid syndrome (CS) in neuroendocrine tumor (NET) patients from the ELECT open label studyPresenter: George Fisher Jr Session: Poster Display Resources: Abstract 936 - Retrospective analysis of the efficacy of somatostatin analogs (SSA) in metastatic pulmonary neuroendocrine tumors and prognostic significance of FDG-PETPresenter: Alberto Bongiovanni Session: Poster Display Resources: Abstract 4213 - Role of somatostatin analogs(SSA)in combination with targeted agents(TTA)for neuroendocrine tumors(NETs)A systematic reviewPresenter: Miguel Beltran Session: Poster Display Resources: Abstract 2684 - Prognostic impact of the cumulative dose and dose intensity of everolimus in patients with pancreatic neuroendocrine tumors (PNETs)Presenter: Rossana Berardi Session: Poster Display Resources: Abstract 2730 - Phase II study of everolimus (EVL) and octreotide (OCT) LAR in patients with non-functioning gastrointestinal neuroendocrine tumours (GI-NETs): EVERLAR studyPresenter: Jaume Capdevila Session: Poster Display Resources: Abstract 2073 - Efficacy and safety of targeted agents for treatment of gastroenteropancreatic (GEP) neuroendocrine tumor (NET)Presenter: Heejung Chae Session: Poster Display Resources: Abstract 1451 - Capecitabine and streptozocin ± cisplatin for gastroenteropancreatic neuroendocrine tumours: predictors of long-term survival in the NET01 trialPresenter: Tim Meyer Session: Poster Display Resources: Abstract 3945 - Progressing G1-G2 neuroendocrine tumors (WD NET) in treatment with capecitabine (Cp) plus somatostatin analog (SSA): a single center experiencePresenter: Riccardo Marconcini Session: Poster Display Resources: Abstract This site uses cookies. Some of these cookies are essential, while others help us improve your experience by providing insights into how the site is being used. For more detailed information on the cookies we use, please check our Privacy Policy.
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