Gemcitabine-induced Thrombocytosis as a Potential Predictive Factor in Non-small Cell Lung Cancer: Analysis of 318 Patients

Canova, Stefania; Cicchiello, Federica; Agustoni, Francesco; Abbate, Maria Ida; Bidoli, Paolo; Cortinovis, Diego

doi:10.5301/tj.5000584

Cited by 5 publications

(11 citation statements)

References 27 publications

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“…Following treatment with gemcitabine combined with probiotics, we observed a notable change in liver enzymes. Gemcitabine caused abnormalities in liver function tests for AST and ALT were reported in 67% and 68%, of cases, respectively 46 . In the present study, a general elevation in liver enzymes was noted after treatment with gemcitabine.…”

Section: Discussionmentioning

confidence: 99%

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The synergistic tumor growth-inhibitory effect of probiotic Lactobacillus on transgenic mouse model of pancreatic cancer treated with gemcitabine

Chen

Chieng

Huang

et al. 2020

Sci Rep

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Pancreatic cancer is one of the most lethal and chemo-resistant cancers worldwide. Growing evidence supports the theory that the gut microbiota plays an essential role in modulating the host response to anti-cancer therapy. The present study aimed to explore the effect of probiotics as an adjuvant during chemotherapy for pancreatic cancer. An LSL-KrasG12D/−-Pdx-1-Cre mouse model of pancreatic ductal adenocarcinoma (PDAC) was created to study the effects of using four-week multi-strain probiotics (Lactobacillus paracasei GMNL-133 and Lactobacillus reuteri GMNL-89) as an adjuvant therapy for controlling cancer progression. At 12 weeks of age, pancreatitis was induced in the mice by two intraperitoneal injection with caerulein (25 μg/kg 2 days apart). Over the next 4 weeks the mice were treated with intraperitoneal injections of gemcitabine in combination with the oral administration of probiotics. The pancreas was then harvested for analysis. Following caerulein treatment, the pancreases of the LSL-KrasG12D/−-Pdx-1-Cre transgenic mice exhibited more extensive pancreatic intraepithelial neoplasia (PanIN) formation. Combined treatment with gemcitabine and probiotics revealed a lower grade of PanIN formation and a decrease in the expression of vimentin and Ki-67. Mice that received gemcitabine in combination with probiotics had lower aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels. Notably, the use of high-dose probiotics alone without gemcitabine also had an inhibitory effect on PanIN changes and serum liver enzyme elevation. These findings suggest that probiotics are able to make standard chemotherapy more effective and could help improve the patient’s tolerance of chemotherapy.

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Section: Discussionmentioning

confidence: 99%

“…In addition, a slight decrease in white blood cells and an increase in platelet levels were observed in mice receiving gemcitabine treatment in the present study. Although thrombocytopenia is a well-known side effect of gemcitabine, thrombocytosis has also been reported 46 .…”

Section: Discussionmentioning

confidence: 99%

The synergistic tumor growth-inhibitory effect of probiotic Lactobacillus on transgenic mouse model of pancreatic cancer treated with gemcitabine

Chen

Chieng

Huang

et al. 2020

Sci Rep

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“…11 Li et al revealed that advanced NSCLC patients with elevated PLT counts (> 200 × 10 9 /L) had significantly poorer PFS compared to patients with PLT counts ≤ 200 × 10 9 / L. 12 In contrast, in studies conducted by Cakar et al and Canova et al, thrombocytosis was not a significant prognostic factor of PFS. 14,15 However, in the study conducted by Canova et al, the PLT count was measured after chemotherapy rather than before treatment. In the study conducted by Cakar et al, both NSCLC and SCLC patients were included.…”

Section: Discussionmentioning

confidence: 99%

“…Previous research has shown that elevated platelet (PLT) count, fibrinogen (FIB) level, and D‐dimer (D‐D) level are all associated with poor prognosis in NSCLC patients, but the results have been inconsistent . The majority of these studies were retrospective single‐center cohorts with relatively small sample sizes.…”

Section: Introductionmentioning

confidence: 99%

“…7 Previous research has shown that elevated platelet (PLT) count, fibrinogen (FIB) level, and D-dimer (D-D) level are all associated with poor prognosis in NSCLC patients, [8][9][10][11][12][13] but the results have been inconsistent. 14,15 The majority of these studies were retrospective single-center cohorts with relatively small sample sizes. Furthermore, no previous study has investigated the combined effects of D-D, FIB, and PLT levels on NSCLC prognosis.…”

Section: Introductionmentioning

confidence: 99%

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Prognostic role of preoperative platelet, fibrinogen, and D‐dimer levels in patients with non‐small cell lung cancer: A multicenter prospective study

Hou

Jiang

et al. 2019

Thoracic Cancer

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BackgroundThe relationships between coagulation factors and non‐small cell lung cancer (NSCLC) prognosis have been intensively studied. However, no previous study has investigated the combined effects of preoperative platelet (PLT), fibrinogen (FIB), and D‐dimer (D‐D) levels on the prognosis of NSCLC.MethodsA multicenter prospective study was conducted over seven hospitals. A total of 395 patients diagnosed with operable NSCLC for the first time were included and followed‐up until disease progression or the end of the study. Baseline demographic and clinicopathological information, and preoperative coagulation test results were collected for each patient. Univariate and multilevel survival analyses were conducted using Cox regression and shared frailty models.ResultsMultilevel analyses revealed that there was a marginally significant association between elevated PLT level (> 215 × 109/L) and unfavorable progression‐free survival (PFS) (hazard ratio 2.42, P = 0.05), whereas preoperative FIB and D‐D were not significant prognostic factors for PFS (P = 0.31 and 0.30, respectively). Compared to patients with one elevation of the three coagulation factors, patients with at least two elevations of the three factors had a significantly higher risk of cancer progression (hazard ratio 4.62, P = 0.02).ConclusionThe number of elevated preoperative coagulation factors may have a significant effect on PFS and could be used to predict the prognosis of NSCLC patients after surgery. Future studies are warranted to further investigate the interactions between these three coagulation factors.

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Clinical course involving thrombocytosis and thrombocytopenia in a patient with bladder cancer treated with gemcitabine and cisplatin

Watanabe

Momo

Tanaka

et al. 2021

Clinical Case Reports

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Gemcitabine-induced Thrombocytosis as a Potential Predictive Factor in Non-small Cell Lung Cancer: Analysis of 318 Patients

Abstract: Thrombocytosis is neither a prognostic nor a predictive factor for PFS or OS in patients with advanced NSCLC treated with first-line gemcitabine-based chemotherapy.

Cited by 5 publications

References 27 publications

The synergistic tumor growth-inhibitory effect of probiotic Lactobacillus on transgenic mouse model of pancreatic cancer treated with gemcitabine

The synergistic tumor growth-inhibitory effect of probiotic Lactobacillus on transgenic mouse model of pancreatic cancer treated with gemcitabine

Prognostic role of preoperative platelet, fibrinogen, and D‐dimer levels in patients with non‐small cell lung cancer: A multicenter prospective study

Clinical course involving thrombocytosis and thrombocytopenia in a patient with bladder cancer treated with gemcitabine and cisplatin

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