Abstract 5139
Background
The prognostic value of the inflammatory indexes (eg. neutrophil-to-lymphocyte ratio, NLR; and systemic immune-inflammation index, SII) was demonstrated among patients with epithelial ovarian cancer (EOC). This study aimed to evaluate their predictive value in terms of platinum-free interval (PFI) as regard to bevacizumab treatment received.
Methods
A total of 375 EOC patients were retrospectively analyzed, 301 treated with chemotherapy alone and 74 with bevacizumab, with the decision to include this drug in the chemotherapy regimen left to the discretion of the treating physician. The correlation between NLR (defined as the ratio of neutrophil to lymphocyte count) and SII, calculated as (platelet count × neutrophil count)/lymphocyte count, and PFI were analyzed using logistic regression analyses adjusted for baseline patient characteristics. Cutoff values were determined using Receiver Operating Characteristic (ROC) analysis.
Results
In univariate analysis, patients with high NLR (≥3) and SII (≥730) had a significantly shorter PFI at 6 and 12 months in overall cohort. In multivariate analysis, only NLR was an independent predictive factor for PFI at 6 months (OR = 2.52, 95% CI 1.30–4.87, p = 0.006) and at 12 months (OR = 2.05, 95% CI 1.05–4.01, p = 0.036) in the overall population and in the chemotherapy group (OR = 2.77, 95% CI 1.38–5.56, p = 0.004; HR = 2.27, 95% CI 1.10–4.70, p = 0.027, respectively). Inflammatory indexes were not predictive for PFI in the bevacizumab group (Table).Table: 1020P
| PFI at 6 months | PFI at 12 months | |||||||
|---|---|---|---|---|---|---|---|---|
| N. pts | N. pts | OR (95% CI) | p | N. pts | N. pts | OR (95% CI) | p | |
| NLR | ||||||||
| <3 | 74 | 139 | 1.00 | 113 | 98 | 1.00 | ||
| ≥3 | 80 | 68 | 2.52 (1.30-4.87) | 0.006 | 106 | 37 | 2.05 (1.05-4.01) | 0.036 |
| SII | ||||||||
| <730 | 52 | 99 | 1.00 | 76 | 73 | 1.00 | ||
| ≥730 | 102 | 108 | 0.74 (0.36-1.53) | 0.413 | 143 | 62 | 0.91 (0.45-1.84) | 0.786 |
| CT | ||||||||
| NLR | ||||||||
| <3 | 62 | 115 | 1.00 | 98 | 78 | 1.00 | ||
| ≥3 | 69 | 48 | 2.77 (1.38-5.56) | 0.004 | 89 | 24 | 2.27 (1.10-4.70) | 0.027 |
| SII | ||||||||
| <730 | 41 | 80 | 1.00 | 63 | 56 | 1.00 | ||
| ≥730 | 90 | 83 | 0.76 (0.35-1.67) | 0.498 | 124 | 46 | 0.84 (0.39-1.82) | 0.663 |
| CT+B | ||||||||
| NLR | ||||||||
| <3 | 12 | 24 | 1.00 | 15 | 20 | 1.00 | ||
| ≥3 | 11 | 20 | 0.47 (0.04-5.15) | 0.538 | 17 | 13 | 0.75 (0.11-5.25) | 0.774 |
| SII | ||||||||
| <730 | 11 | 19 | 1.00 | 13 | 17 | 1.00 | ||
| ≥730 | 12 | 25 | 1.65 (0.13-20.56) | 0.696 | 19 | 16 | 1.78 (0.21-15.14) | 0.599 |
Conclusions
The NLR was an independent predictive factor for platinum-sensitivity in patients with EOC treated with chemotherapy. Its predictive role seems to be lost in patients treated with bevacizumab.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
MITO group.
Funding
MITO group.
Disclosure
All authors have declared no conflicts of interest.
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