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The Prognostic Valu...
The Prognostic Value of Pre-Treatment Circulating Biomarkers of Systemic Inflammation (CRP, dNLR, YKL-40, and IL-6) in Vulnerable Older Patients with Metastatic Colorectal Cancer Receiving Palliative Chemotherapy-The Randomized NORDIC9-Study
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- Liposits, Gabor (author)
- Odense Univ Hosp, Dept Oncol, DK-5000 Odense, Denmark.;Univ Southern Denmark, Dept Clin Res, DK-5000 Odense, Denmark.;Acad Geriatr Canc Res AgeCare, DK-5000 Odense, Denmark.
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- Skuladottir, Halla (author)
- Reg Hosp Godstrup, Dept Oncol, DK-7400 Herning, Denmark.
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- Ryg, Jesper (author)
- Univ Southern Denmark, Dept Clin Res, DK-5000 Odense, Denmark.;Acad Geriatr Canc Res AgeCare, DK-5000 Odense, Denmark.;Odense Univ Hosp, Dept Geriatr Med, DK-5000 Odense, Denmark.
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- Winther, Stine Braendegaard (author)
- Odense Univ Hosp, Dept Oncol, DK-5000 Odense, Denmark.;Acad Geriatr Canc Res AgeCare, DK-5000 Odense, Denmark.
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- Moller, Soren (author)
- Univ Southern Denmark, Dept Clin Res, DK-5000 Odense, Denmark.;Odense Univ Hosp, OPEN Open Patient Data Explorat Network, DK-5000 Odense, Denmark.
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- Hofsli, Eva (author)
- Trondheim Reg & Univ Hosp, Dept Oncol, N-7030 Trondheim, Norway.;Norwegian Univ Sci & Technol, Dept Clin & Mol Med, N-7030 Trondheim, Norway.
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- Shah, Carl-Henrik (author)
- Karolinska Univ Hosp, Theme Canc, S-17176 Stockholm, Sweden.
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- Poulsen, Laurids Ostergaard (author)
- Aalborg Univ Hosp, Dept Oncol, DK-9000 Aalborg, Denmark.
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- Berglund, Åke (author)
- Uppsala universitet,Institutionen för immunologi, genetik och patologi
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- Qvortrup, Camilla (author)
- Acad Geriatr Canc Res AgeCare, DK-5000 Odense, Denmark.
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- Osterlund, Pia (author)
- Karolinska Institutet
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- Johansen, Julia S. (author)
- Copenhagen Univ Hosp, Dept Med, DK-2730 Herlev, Denmark.;Copenhagen Univ Hosp, Dept Oncol, DK-2730 Herlev, Denmark.;Univ Copenhagen, Fac Hlth & Med Sci, Dept Clin Med, DK-2200 Copenhagen, Denmark.
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- Glimelius, Bengt (author)
- Uppsala universitet,Institutionen för immunologi, genetik och patologi
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- Sorbye, Halfdan (author)
- Haukeland Hosp, Dept Oncol, N-5021 Bergen, Norway.;Univ Bergen, Dept Clin Sci, N-5021 Bergen, Norway.
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- Pfeiffer, Per (author)
- Odense Univ Hosp, Dept Oncol, DK-5000 Odense, Denmark.;Univ Southern Denmark, Dept Clin Res, DK-5000 Odense, Denmark.;Acad Geriatr Canc Res AgeCare, DK-5000 Odense, Denmark.
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Odense Univ Hosp, Dept Oncol, DK-5000 Odense, Denmark;Univ Southern Denmark, Dept Clin Res, DK-5000 Odense, Denmark.;Acad Geriatr Canc Res AgeCare, DK-5000 Odense, Denmark. Reg Hosp Godstrup, Dept Oncol, DK-7400 Herning, Denmark. (creator_code:org_t)
- 2022-09-23
- 2022
- English.
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In: Journal of Clinical Medicine. - : MDPI. - 2077-0383. ; 11:19
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Abstract
Subject headings
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- Appropriate patient selection for palliative chemotherapy is crucial in patients with metastatic colorectal cancer (mCRC). We investigated the prognostic value of C-reactive protein (CRP), derived neutrophil-to-lymphocyte ratio (dNLR), Interleukin (IL)-6, and YKL-40 on progression-free survival (PFS) and overall survival (OS) in the NORDIC9 cohort. The randomized NORDIC9-study included patients >= 70 years with mCRC not candidates for standard full-dose combination chemotherapy. Participants received either full-dose S1 (Teysuno) or a dose-reduced S1 plus oxaliplatin. Blood samples were collected at baseline and biomarkers were dichotomized according to standard cut-offs. Multivariable analyses adjusted for age, sex, ECOG performance status, and treatment allocation; furthermore, C-statistics were estimated. In total, 160 patients with a median age of 78 years (IQR: 76-81) were included between 2015 and 2017. All investigated biomarkers were significantly elevated in patients with either weight loss, >= 3 metastatic sites, or primary tumor in situ. In multivariable analyses, all markers showed significant association with OS; the highest HR was observed for CRP (HR = 3.40, 95%CI: 2.20-5.26, p < 0.001). Regarding PFS, statistically significant differences were found for CRP and IL-6, but not for dNLR and YKL-40. Applying C-statistics, CRP indicated a good prognostic model for OS (AUC = 0.72, 95%CI: 0.67-0.76). CRP is an easily available biomarker, which may support therapeutic decision-making in vulnerable older patients with mCRC.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
Keyword
- older patients
- colorectal cancer
- frailty
- biomarker
- C-reactive protein
- neutrophil-to-lymphocyte ratio
- Interleukin-6
- YKL-40
- chemotherapy
- survival
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Liposits, Gabor
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Skuladottir, Hal ...
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Ryg, Jesper
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Winther, Stine B ...
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Moller, Soren
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Hofsli, Eva
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Shah, Carl-Henri ...
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Poulsen, Laurids ...
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Berglund, Åke
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Qvortrup, Camill ...
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Osterlund, Pia
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Johansen, Julia ...
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Glimelius, Bengt
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Sorbye, Halfdan
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Pfeiffer, Per
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cancer and Oncol ...
- Articles in the publication
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Journal of Clini ...
- By the university
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Uppsala University
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Karolinska Institutet