Abstract 5416
Background
Emerging data suggest that sex-related immune system composition affect both immune response and efficacy of immunotherapy in cancer patients (pts). This study aimed to investigate the sex-related prognostic role of MLR in metastatic colorectal cancer (mCRC) pts.
Methods
We analyzed a retrospective consecutive cohort of 490 mCRC pts treated in 2004-2017 at the Oncology Departments of Aviano and Pordenone (training set) and Udine (validation set), Italy. Association analysis was explored by Chi-squared or Kruskal-Wallis test, as appropriate. The prognostic impact of MLR on overall survival (OS) was evaluated with uni- and multivariable Cox regression models. The best cut-off value to predict survival was defined through ROC analyses.
Results
Overall, we identified 288 males and 202 females; 161 pts (33%) had a right cancer and 324 (67%) a left one. Interestingly, sex was associated with MLR (p = 0.004). The obtained cut-off value for MLR in females and males was 0.27 and 0.49, respectively. At univariate analysis of training set, MLR >0.27 in females (HR 1.95, p = 0.003) and MLR >0.49 in males (HR 2.65, p = 0.010) were associated with poorer OS. Even in the validation set, MLR >0.27 in females (HR 2.21, p = 0.010) and MLR >0.49 in males (HR 2.99, p = 0.002) were associated with shorter OS. In the overall cohort, at univariate analysis MLR >0.27 in females (HR 2.07, p ≤ 0.001), MLR >0.49 in males (HR 2.87, p ≤ 0.001), KRAS mutation (HR 1.37 p = 0.008), BRAF mutation (HR 1.69 p = 0.009), sidedness (right vs left HR 1.59, p ≤ 0.001) and peritoneal metastases (HR 2.32, p ≤ 0.001) were associated with shorter OS. Instead, primary tumor resection (HR 0.37 p ≤ 0.001) was associated with prolonged OS. At multivariate analysis, MLR >0.27 in females (HR 2.77, p = 0.002), MLR >0.49 in males (HR 5.39, p ≤ 0.001), BRAF mutation (HR 3.38, p ≤ 0.001) and peritoneal metastases (HR 2.50, p = 0.003) were still independently associated with worse OS. Noteworthy, high MLR was more frequently found in females than in males (41% vs 9%).
Conclusions
Males and females have a different immune response. Our study showed that high MLR, both in males and females, is an unfavorable independent prognostic factor. Further prospective studies are needed to confirm these data.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
IRCCS CRO National Cancer Institute, Aviano, Italy.
Funding
Has not received any funding.
Disclosure
F. Puglisi: Advisory / Consultancy, Speaker Bureau / Expert testimony, Research grant / Funding (institution), Travel / Accommodation / Expenses: Hoffmann-La Roche; Honoraria (self), Advisory / Consultancy, Speaker Bureau / Expert testimony, Travel / Accommodation / Expenses: Amgen; Advisory / Consultancy, Speaker Bureau / Expert testimony, Research grant / Funding (institution), Travel / Accommodation / Expenses: AstraZeneca; Advisory / Consultancy, Speaker Bureau / Expert testimony, Travel / Accommodation / Expenses: Celgene; Advisory / Consultancy, Speaker Bureau / Expert testimony, Travel / Accommodation / Expenses: Eisai; Advisory / Consultancy, Speaker Bureau / Expert testimony, Travel / Accommodation / Expenses: Eli Lilly; Honoraria (self), Advisory / Consultancy, Speaker Bureau / Expert testimony, Research grant / Funding (institution): Ipsen; Advisory / Consultancy, Speaker Bureau / Expert testimony, Travel / Accommodation / Expenses: Novartis; Honoraria (self), Advisory / Consultancy, Speaker Bureau / Expert testimony, Travel / Accommodation / Expenses: Pierre-Fabre; Advisory / Consultancy, Speaker Bureau / Expert testimony, Research grant / Funding (institution): Pfizer; Advisory / Consultancy, Speaker Bureau / Expert testimony, Travel / Accommodation / Expenses: Takeda; Advisory / Consultancy: Merck Sharp & Dohme. All other authors have declared no conflicts of interest.
Resources from the same session
3425 - Feasibility and impact of prospective DPYD screening in the Irish population
Presenter: Mohammed Zameer
Session: Poster Display session 2
Resources:
Abstract
1972 - Diet-derived metabolites and the risk of colorectal cancer: a nested case-control study in a population-based cohort, the Singapore Chinese Health Study
Presenter: Dawn Chong
Session: Poster Display session 2
Resources:
Abstract
4103 - Loss of subcutaneous adipose tissue during chemotherapy predicts reduced survival in patients with incurable colorectal cancer undergoing palliative therapy
Presenter: Erin Stella Sullivan
Session: Poster Display session 2
Resources:
Abstract
4309 - Obese and overweight is associated with better prognosis in metastatic colorectal cancer patients treated with bevacizumab.
Presenter: Bozena Cybulska-Stopa
Session: Poster Display session 2
Resources:
Abstract
3554 - Patient characteristics associated with poor performance status, ECOG 2-3, and effect on survival in 1086 Finnish metastatic colorectal cancers (mCRC) nationwide (prospective RAXO study)
Presenter: Pia Österlund
Session: Poster Display session 2
Resources:
Abstract
4572 - Discovery and Diagnosis of Metastatic Colorectal Cancer (mCRC) in the Real World: Final Results from a European Survey
Presenter: Iga Rawicka
Session: Poster Display session 2
Resources:
Abstract
4783 - Adherence to recommended intake of calcium and colorectal cancer risk in the HEXA study
Presenter: Jeeyoo Lee
Session: Poster Display session 2
Resources:
Abstract
5106 - Body size, sex and sidedness of incident colorectal cancer in a prospective Swedish cohort study
Presenter: Christina Siesing
Session: Poster Display session 2
Resources:
Abstract
3364 - Middle East & North Africa Registry to characterize RAS mutation status and tumor specifications in recently diagnosed patients with metastatic colorectal cancer (MORE-RAS Study)
Presenter: Mohamed Oukkal
Session: Poster Display session 2
Resources:
Abstract
3668 - Patient Demographics and Management Landscape of Metastatic Colorectal Cancer in the Third Line Setting: real-world data in an Australian Population
Presenter: Sandy Tun Min
Session: Poster Display session 2
Resources:
Abstract