Association of peripheral blood cell count-derived ratios, biomarkers of inflammatory response and tumor growth with outcome in previously treated metastatic colorectal carcinoma patients receiving cetuximab

Melichar, Bohuslav; Hrůzová, Klára; Krčmová, Lenka Kujovská; Javorská, Lenka; Pešková, Eliška; Solichová, Dagmar; Hyšpler, Radomı́r; Malířová, Eva; Vošmik, Milan; Bartoušková, Marie; Klos, Dušan; Študentová, Hana

doi:10.1515/pterid-2017-0016

Cited by 1 publication

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“…Because repeated measurements of peripheral blood cell counts are available for virtually all patients, simple indices derived from these, such as NLR or PLR, have been introduced in retrospective studies. It has been demonstrated in individual studies as well as in meta-analyses that these peripheral blood cell count-derived ratios predict prognosis across a range of solid tumors (33)(34)(35). However, this approach has certain limitations for multicentric studies as different methods of differential count determination may result in significant differences in peripheral blood cell countderived ratios (36).…”

Section: Discussionmentioning

confidence: 99%

Chronic Inflammation as a Potential Predictive Factor of Nivolumab Therapy in Non-small Cell Lung Cancer

et al. 2018

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Aim: To investigate potential associations between clinical and standard peripheral blood biomarkers and clinical outcome in patients with non-small cell lung cancer (NSCLC) treated with nivolumab. Patients and Methods: A total of 120 patients with advanced NSCLC treated at seven comprehensive cancer care centers were analyzed in this national retrospective study. Survival statistics were evaluated using the Kaplan-Meier method and Cox analysis. Results: Among clinical parameters, histology was significantly associated with progression-free survival. Univariate Cox-proportional hazards model indicated prognostic and predictive role of a panel of laboratory parameters reflecting chronic inflammatory pattern (elevated neutrophil count, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, C-reactive protein and decrease in hemoglobin and albumin). Higher serum calcium concentration was also associated with nivolumab treatment effect. Conclusion: Tumor histology was the only clinical parameter predicting the outcome of nivolumab treatment.Among the laboratory parameters, our analysis identified a laboratory panel reflecting chronic inflammation as a potential predictive marker of nivolumab treatment.Nivolumab is a human monoclonal anti-programed cell death 1 (PD-1) therapy that represents a new therapeutic option in the second-line treatment of advanced non-small cell lung cancer (NSCLC). Improved efficacy and a more favorable adverse event profile have been documented for nivolumab compared to docetaxel in phase III studies. However, the objective response rate on nivolumab monotherapy is only about 20%, with the disease control rate reaching approximately 50% (1, 2). Therefore, many patients do not benefit from nivolumab treatment and, taking into account the cost/efficacy ratio, identification of predictive parameters that would aid identification of the most suitable candidates for this therapy remains a topic of high unmet medical need. Much effort has been made to demonstrate that programmed death-ligand 1 (PD-L1) expression on tumor cells represent, a potential biomarker of response to anti-PD1 therapy (3, 4). However, for nivolumab, this seems to hold true in nonsquamous NSCLC only, although data for other drugs, e.g. pembrolizumab, have demonstrated the predictive role of PD-L1 expression even in patients with squamous histology (5). For various reasons, PD-L1 expression is still not an ideal biomarker (6). Therefore, the search for other predictive biomarkers should continue. Several approaches 6771

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