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 session2826 - A multicenter phase II study of preoperative concurrent chemoradiotherapy with S-1 plus irinotecan for locally advanced rectal cancer: SAMRAI-2Presenter: Masafumi Noda Session: Poster Display Resources: Abstract 3036 - Temozolimide and capecitabine in patients with refractory KRAS wildtype metastatic colorectal cancer. A phase II trialPresenter: Camilla Qvortrup Session: Poster Display Resources: Abstract 3423 - Nivolumab ± ipilimumab treatment (Tx) efficacy, safety, and biomarkers in patients (Pts) with metastatic colorectal cancer (mCRC) with and without high microsatellite instability (MSI-H): results from the CheckMate-142 studyPresenter: Michael Overman Session: Poster Display Resources: Abstract 3597 - MErCuRIC1: A phase 1a study of MEK1/2 inhibitor PD-0325901 with cMET inhibitor crizotinib in patients with advanced solid tumoursPresenter: Richard Wilson Session: Poster Display Resources: Abstract 843 - The correlation between tumor regression grade and retrieved lymph nodes status in locally advanced rectal cancer after neoadjuvant treatment: results from a prospective studyPresenter: Jianwei Zhang Session: Poster Display Resources: Abstract 966 - Importance of tumour symptoms and extent of disease on efficacy of first-line FOLFOX4 ± panitumumab (pmab) in patients (pts) with RAS wild-type (WT)/BRAF WT metastatic colorectal cancer (mCRC) in the PRIME studyPresenter: Julien Taieb Session: Poster Display Resources: Abstract 1202 - Effect of 5 years of imaging and CEA follow-up to detect recurrence of colorectal cancer - PRODIGE 13 a FFCD and Unicancer phase III trial: baseline characteristicsPresenter: Côme Lepage Session: Poster Display Resources: Abstract 1319 - A multicenter phase II trial to evaluate the efficacy of mFOLFOX6 + cetuximab as induction chemotherapy to achieve R0 surgical resection for advanced colorectal liver metastases (NEXTO trial)Presenter: Kiyoshi Hasegawa Session: Poster Display Resources: Abstract 1723 - Impact of depth of response (DpR) on survival in patients (pts) with RAS wild-type (WT) metastatic colorectal cancer (mCRC) receiving first-line panitumumab + FOLFOX4 vs FOLFOX4Presenter: Salvatore Siena Session: Poster Display Resources: Abstract 1804 - Brain metastasis in advanced colorectal cancer: Results from the South Australian metastatic colorectal cancer (SAmCRC) registryPresenter: Timothy Price 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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