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 | |||
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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 session2315 - VISMONEO - a phase II study assessing vismodegib in the neoadjuvant treatment of locally advanced basal cell carcinoma - Patients characteristicsPresenter: Nicole Basset-Seguin Session: Poster display Resources: Abstract 3631 - Virological studies in the secondary prevention of cervical cancerPresenter: Elena Bakhidze Session: Poster Display Resources: Abstract 2553 - VICTOR: Vinflunine in advanced metastatic transitional cell carcinoma of the urothelium (TCCU): a retrospective analysis of the use of vinflunine in multi-centre real life setting as second line chemotherapy through free of charge programme (FOCP) for patients in the UK and IrelandPresenter: Syed Hussain Session: Poster display Resources: Abstract 3727 - VEGF, VEGFR2 and GSTM1 polymorphisms in outcome of multiple myeloma patients in the thalidomide eraPresenter: Leisa Lopes-Aguiar Session: Poster Display Resources: Abstract 3398 - Vascular endothelial growth factor (VEGF) polymorphisms and outcome of epithelial ovarian cancer patientsPresenter: Angelo Brito Session: Poster Display Resources: Abstract 1059 - Valuing the effect sizes hypothesized in phase 3 trials published from 2005 to 2015Presenter: Nicola Lawrence Session: Poster display Resources: Abstract 720 - Validation of novel diagnostic kits using the semi-dry dot-blot method for detecting metastatic lymph nodes in breast cancer; distinguishing macrometastases and micrometastasesPresenter: Ryota Otsubo Session: Poster display Resources: Abstract 3095 - Validation of a risk-assessment score for prediction of venous thromboembolism in cancer outpatients receiving active treatments: ONKOTEV-2 trialPresenter: Chiara Alessandra Cella Session: Poster display Resources: Abstract 1032 - Vaccination perception and attitudes among patients with cancer receiving chemotherapyPresenter: Serkan Akin Session: Poster display Resources: Abstract 2241 - Utility of multidisciplinary tumor board (MTB) in the management of hepatocellular cancer (HCC)Presenter: Asrar Alahmadi 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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