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 session2904 - Ultra-sensitive mass spectrometry allows 33% increased detection of somatic EGFR T790M mutation in plasma cfDNA samplesPresenter: Raphael Saffroy Session: Poster display Resources: Abstract 3616 - Ultra-rapid, sensitive, and fully automated extended RAS testing for metastatic colorectal cancer – evaluation of an NRAS/BRAF/EGFR492 modulePresenter: Ellen Vercauteren Session: Poster display Resources: Abstract 3651 - UK phase IV, observational study to assess quality of life in patients (pts) with pancreatic neuroendocrine tumours (pNETS) receiving treatment with everolimus: The “real-world” OBLIQUE studyPresenter: John Ramage Session: Poster Display Resources: Abstract 1618 - Tyrosine kinase inhibitors targeted therapy and the AKT-m-TOR pathway in kidney cancer tissuesPresenter: Liudmila Spirina Session: Poster display Resources: Abstract 3974 - Tyrosine kinase inhibitors alone as a first-line treatment for patients with non-small-cell lung cancer harboring mutant epidermal growth factor receptorPresenter: Toshihiko Iuchi Session: Poster Display Resources: Abstract 3506 - Typing of non-small cell lung carcinoma and investigation of enteric differentiation in small biopsy specimensPresenter: aYŞEGÜL Erol Session: Poster display Resources: Abstract 3511 - Tumor-infiltrating lymphocytes (TILs) density as prognostic determinant in stage II colorectal cancerPresenter: Cristiana Lo Nigro Session: Poster Display Resources: Abstract 1872 - Tumor response from phase II study of combination treatment with intratumoral HF10, a replication-competent HSV-1 oncolytic virus, and ipilimumab in patients with stage IIIB, IIIC, or IV unresectable or metastatic melanomaPresenter: Robert Andtbacka Session: Poster display Resources: Abstract 2120 - Tumor mutation load assessed by FoundationOne (FM1) is associated with improved efficacy of atezolizumab (atezo) in patients with advanced NSCLCPresenter: Marcin Kowanetz Session: Poster display Resources: Abstract 3287 - Tumor lymphocyte infiltrations decrease the risk of late relapse in breast cancer patientsPresenter: Cvetka Grasic Kuhar 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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