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 session2382 - First-line (1-L) bevacizumab plus chemotherapy (Bev/CT) in colorectal cancer (CRC) patients with potentially resectable liver only (LM) or liver and lung metastases (LLM): KRAS mutation analysis of the non-interventional PICASSO studyPresenter: David Malka Session: Poster Display Resources: Abstract 2813 - Survival after resection of colorectal cancer with synchronous metastases – a Danish population based historical cohort studyPresenter: Anders Boysen Session: Poster Display Resources: Abstract 2997 - Perioperative triplet chemotherapy plus bevacizumab (bev) in patients with borderline resectable colorectal cancer liver metastases (CLM): Preliminary safety and activityPresenter: Alessia Mennitto Session: Poster Display Resources: Abstract 3108 - Phase 2 of intra-arterial hepatic (IAH) bevacizumab with systemic chemotherapy (CT) in second line treatment of liver metastases of colorectal cancer (LMCRC)Presenter: Michel Ducreux Session: Poster Display Resources: Abstract 3306 - Impact of surgical resection of liver metastases on outcome of patients with KRAS-wildtype exon 2 (KRAS-wt) metastatic colorectal carcinoma (mCRC) treated with a cetuximab-based first-line therapy - Interim analysis of the German non-interventional study ERBITAGPresenter: Ulf Neumann Session: Poster Display Resources: Abstract 3486 - Selective internal radiation therapy (SIRT) in metastatic colorectal cancer (mCRC): Safety, efficacy and survival outcomes from the South Australian registryPresenter: Adeola Ayoola Session: Poster Display Resources: Abstract 3869 - Secondary resectability rates observed in a multicenter randomized phase II study of modified capecitabine/irinotecan (mXELIRI) plus bevacizumab (bev) followed by capecitabine/oxaliplatin (XELOX) plus bev or the reverse sequence in patients with metastatic colorectal cancer (mCRC)Presenter: Werner Scheithauer Session: Poster Display Resources: Abstract 4017 - DC-beads loaded with irinotecan combined with systemic chemotherapy for pretreated liver dominant metastatic colorectal cancer: Procedure and outcomes of 49 patientsPresenter: Anne-Laure Pointet Session: Poster Display Resources: Abstract 915 - Cetuximab (Cmab) plus irinotecan (I) versus panitumumab (Pmab) in patients with refractory metastatic colorectal cancer (mCRC) in OntarioPresenter: Katarzyna Jerzak Session: Poster Display Resources: Abstract 933 - A triplet combination with oxaliplatin/capecitabine/irinotecan (XELOXIRI) plus cetuximab (Cmab) as a first-line therapy in wild-type KRAS, metastatic colorectal cancer: a dose escalating studyPresenter: Yasushi Sato 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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