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
1058 - Assessment of CPS+EG, Neo-Bioscore and modified Neo-Bioscore in breast cancer patients treated with preoperative systemic therapy: a multicenter cohort study
Presenter: LING XU
Session: Poster Display session 2
Resources:
Abstract
1156 - The concordance of treatment decision guided by Oncotype and the PREDICT tool in early stage breast cancer
Presenter: Hadar Goldvaser
Session: Poster Display session 2
Resources:
Abstract
3447 - Influence of first treatment delay on survival among breast cancer subtypes
Presenter: Irene Zarcos Pedrinaci
Session: Poster Display session 2
Resources:
Abstract
3505 - Clinical features of early-stage (I-III) triple-negative breast cancer (TNBC) patients with tumors exhibiting low-overall change in molecular profile after neoadjuvant therapy.
Presenter: Nour Abuhadra
Session: Poster Display session 2
Resources:
Abstract
5442 - Meta-analysis in HER2+ early breast cancer therapies and cost-effectiveness in a Brazilian perspective
Presenter: Marcos Magalhaes
Session: Poster Display session 2
Resources:
Abstract
1570 - Anti-mullerian hormone (AMH) levels and antral follicle counts (AFC) may predict ovarian reserves before systemic chemotherapy (SC) in women with breast cancer(BC); a prospective clinical study
Presenter: Cetin Ordu
Session: Poster Display session 2
Resources:
Abstract
2698 - Prognosis of selected triple negative apocrine breast cancer patients who did not receive adjuvant chemotherapy.
Presenter: Giuseppe Cancello
Session: Poster Display session 2
Resources:
Abstract
3104 - Novel Blood Based Circulating Tumor Cell Biomarker For Breast Cancer Detection
Presenter: Chun-Yu Liu
Session: Poster Display session 2
Resources:
Abstract
4631 - Multi-Gene Prognostic Signatures and Prediction of Pathological Complete Response of ER-Positive HER2-Negative Breast Cancer Patients to Neo-Adjuvant Chemotherapy
Presenter: Claudia Mazo
Session: Poster Display session 2
Resources:
Abstract
4632 - Impact of menopause status on breast cancer outcomes and amenorrhea incidence during adjuvant tailored dose dense chemotherapy
Presenter: Andri Papakonstantinou
Session: Poster Display session 2
Resources:
Abstract