接受瑞戈非尼治疗的经治结直肠癌患者的预后临床因素：对临床管理的意义

Prognostic clinical factors in pretreated colorectal cancer patients receiving regorafenib: implications for clinical management.

作者信息

Del Prete Michela, Giampieri Riccardo, Loupakis Fotios, Prochilo Tiziana, Salvatore Lisa, Faloppi Luca, Bianconi Maristella, Bittoni Alessandro, Aprile Giuseppe, Zaniboni Alberto, Falcone Alfredo, Scartozzi Mario, Cascinu Stefano

机构信息

Medical Oncology, AO Ospedali Riuniti-Università Politecnica delle Marche, Ancona, Italy.

Medical Oncology, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.

出版信息

Oncotarget. 2015 Oct 20;6(32):33982-92. doi: 10.18632/oncotarget.5053.

BACKGROUND

We assessed the impact on survival of angiogenesis and inflammation-related factors, particularly LDH serum levels, platelet, neutrophil and lymphocyte counts, and neutrophil-to-lymphocyte ratio (NLR), in metastatic colorectal cancer patients receiving regorafenib monotherapy.

METHODS

LDH serum levels, neutrophil, lymphocyte and platelet counts were collected at the start of regorafenib monotherapy. Cut-off values were calculated by ROC curve analysis. Survival analyses were performed by Kaplan-Meier method, and multivariate analysis by Cox method.

RESULTS

A total of 208 patients were eligible for analysis. Among factors who were related with worse overall survival and who maintained their role at the multivariate analysis, high platelet count (Exp(b):1.4963, 95% CI:1.0130-2.2103, p = 0.0439) and high neutrophil/lymphocyte ratio (Exp(b):1.6963, 95% CI:1.0757-2.6751, p = 0.0237) were those who more deeply were related to worse overall survival. High lymphocyte count (Exp(b):0.4527, 95% CI:0.2801-0.7316, p = 0.0013) was correlated with improved overall survival.

CONCLUSIONS

High neutrophil, high platelet, low lymphocyte count and/or high NLR may represent negative prognostic factors in patients receiving regorafenib monotherapy. It is advisable that these factors are taken into account in the design of subsequent trials in colorectal cancer patients receiving this drug.

背景

我们评估了血管生成和炎症相关因子，特别是乳酸脱氢酶（LDH）血清水平、血小板、中性粒细胞和淋巴细胞计数以及中性粒细胞与淋巴细胞比值（NLR）对接受瑞戈非尼单药治疗的转移性结直肠癌患者生存的影响。

方法

在瑞戈非尼单药治疗开始时收集LDH血清水平、中性粒细胞、淋巴细胞和血小板计数。通过ROC曲线分析计算临界值。采用Kaplan-Meier方法进行生存分析，采用Cox方法进行多变量分析。

结果

共有208例患者符合分析条件。在与较差总生存期相关且在多变量分析中仍起作用的因素中，高血小板计数（Exp(b)：1.4963，95%可信区间：1.0130-2.2103，p = 0.0439）和高中性粒细胞/淋巴细胞比值（Exp(b)：1.6963，95%可信区间：1.0757-2.6751，p = 0.0237）与较差总生存期的相关性更强。高淋巴细胞计数（Exp(b)：0.4527，95%可信区间：0.2801-0.7316，p = 0.0013）与总生存期改善相关。