Abstract 588P
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 sessionUpdated, expanded analysis with next generation sequencing (NGS) of biliary tract cancer confirms association between tumor somatic variants and chemotherapy resistancePresenter: Daniel Ahn Session: Poster Display Resources: Abstract Updated results from a phase I study of nivolumab (Nivo) in combination with ipilimumab (Ipi) in metastatic renal cell carcinoma (mRCC): The CheckMate 016 studyPresenter: Hans Hammers Session: Poster display Resources: Abstract Updated report: A randomized, double-blind, placebo-controlled phase II study of prophylactic dexamethasone (dex) therapy for fatigue and malaise due to regorafenib in patient (pts) with metastatic colorectal cancer (mCRC): (KSCC1402/HGCSG1402)Presenter: Satoshi Yuki Session: Poster Display Resources: Abstract Updated efficacy and safety from the global phase II NP28673 study of alectinib in patients (pts) with previously treated ALK+ non-small-cell lung cancer (NSCLC)Presenter: Fabrice Barlesi Session: Poster Display Resources: Abstract Update of the T-DIS randomized phase II trial: Trabectedin rechallenge versus continuation in patients (pts) with advanced soft tissue sarcoma (ASTS)Presenter: Nuria Kotecki Session: Poster display Resources: Abstract Unsupervised latent class analysis of adult glioma variant profiles reveals biologically and clinically relevant subclassesPresenter: Manna Chang Session: Poster display Resources: Abstract Underutilization of G-CSF in elderly cancer patients – an issue that needs to be urgently addressedPresenter: Marika Saar Session: Poster display Resources: Abstract Undertreatment of cancer pain - a retrospective analysis of medical records of advanced cancer patients hospitalized in a palliative care departmentPresenter: Nikolay Yordanov Session: Poster display Resources: Abstract Understanding real world treatment patterns, healthcare resource utilization (HRU) and costs among metastatic renal cell carcinoma (mRCC) patientsPresenter: Ronda Copher Session: Poster display Resources: Abstract Ultrasound-guided core needle biopsy could replace sentinel lymph nodes biopsy for patients with suspicious node positive breast cancerPresenter: RIKIYA Nakamura 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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