The A.L.A.N. score identifies prognostic classes in advanced biliary cancer patients receiving first-line chemotherapy

Abstract

exploratory cohort. When combined in the multiplex, A.L.A.N. score was able to identify three classes of ABC patients with significantly different OS (high-risk: median OS, 5 months; intermediate-risk: median OS, 12 months and low-risk: median OS, 22 months; p:<0.001). The score performed well in the different subtypes of ABC and was independent of stage, performance status and chemotherapy regimen. The performance of the A.L.A.N. score was confirmed in a validation cohort of cholangiocarcinoma patients (high-risk: median OS, 4.3 months; intermediate-risk: median OS 9.3 months, low-risk: median OS 13 months; p:0.005). Conclusions: The A.L.A.N score can be derived by variables routinely recorded in clinical practice and can provide prognostic assessment of ABC patients considered for first-line treatment.

Risk Stratification in Advanced Biliary Tract Cancer: Validation of the A.L.A.N. Score

“…However, even though risk stratification according to the A.L.A.N. score resulted in significant divergence of Kaplan-Meier curves in our cohort, concordance index calculation provides the probability that a randomly selected patient who experienced an event (in our case, death) had a [25]. † Other chemotherapy regimens for our cohort were: gemcitabine and sorafenib (n � 12); capecitabine and oxaliplatin (n � 5); capecitabine (n � 3); gemcitabine and oxaliplatin (n � 2); fluorouracil and imantinib (n � 2); fluorouracil, folinic acid, and irinotecan (n � 1); cisplatin and fluorouracil (n � 1); irinotecan (n � 1); oxaliplatin (n � 1).…”

“…To ensure comparability with the original study, we included the same risk factors in a multivariate model [25]. A high A.L.A.N.…”

“…Recently, Salati et al proposed their A.L.A.N. (actual neutrophil count, lymphocyte-to-monocyte ratio, albumin, neutrophil-to-lymphocyte ratio) score (for ABC patients receiving first-line chemotherapy [ 25 ]. This score combined one function-related biochemical parameter with three immune-inflammatory markers and resulted in a significant stratification regarding OS in their cohorts.…”

The prognostic nutritional index predicts survival and response to first‐line chemotherapy in advanced biliary cancer

“…[12][13][14][15][16] Nevertheless, none of these has been convincingly validated and the power of single factors in predicting survival is limited. 17,18 Additionally, growing research interest is headed to novel biomarkers with potential predictive and prognostic value such as non-coding RNAs and exosomal proteins, [19][20][21] though this research field is still in its infancy. Hence, there remains an unmet need for a more accurate patients' stratification to inform clinical decision making as well as a rationale trials design.…”

“…In the literature, several clinical and biochemical factors have been described as prognostic factors in ABC, such as Eastern Cooperative Oncology Group performance status (ECOG PS), primary tumour location, disease status, number of metastatic sites, haemoglobin, bilirubin, LDH and neutrophil‐to‐lymphocyte ratio . Nevertheless, none of these has been convincingly validated and the power of single factors in predicting survival is limited . Additionally, growing research interest is headed to novel biomarkers with potential predictive and prognostic value such as non‐coding RNAs and exosomal proteins, though this research field is still in its infancy.…”