The prognostic role of tumour inflammation markers in patients (pts) with colorectal cancer (CRC) treated with trifluridine/tipiuracil hydrochloride: Real-world data (RWD) from Greater Manchester
Ho, Adrienne K
Saunders, Mark P
Braun, Michael S
AffiliationGeneral Medicine, The Christie NHS Foundation Trust, Manchester, UK
MetadataShow full item record
AbstractBackground: Trifluridine/Tipiuracil hydrochloride (TFT) has been shown to improve progression free survival (PFS) and overall survival (OS) in pts with stage IV CRC. We evaluated the neutrophil to lymphocyte ratio (NLR), platelet (P) to LR, monocyte (M) to LR and systemic inflammatory response index (SIRI) as a stratification tool for patients (pts) receiving TFT. Methods: All consecutive pts who received TFT between August 2016 and August 2019 were included. Univariate survival analysis was performed with Kaplan-Meier curve and log-rank test. Cox regression was used for multivariable analysis (MVA). All indexes tested were dichotomised by their median value. Results: One hundred and eighty-eight pts were analysed; median follow up was 7.1 months (mos). Median age was 66. RAS mutation was identified in 29.8% of pts; 134 (74%), 120 (66%) and 70 (40%) had liver, lung and peritoneal metastasis, respectively; 64 pts (34%) had good prognostic characteristics (GPC) (<3 metastatic sites and 18 mos since first metastasis). Median baseline neutrophils (N)s 4.5 10t9/L, lymphocytes (Ls) 1.2 10t9/L, monocytes (Ms) 0.5 10 9/L and platelets (Ps9 218 10t9/L; 14% had performance status (PS) 0 and 78% had a PS1. 5% of patients had PS2 and data was missing in 3%. Neutropenia was observed in 133 pts (71%), 64 (34%) with grade 3 and 25 (13.2 %) with febrile neutropenia. Median OS for the cohort was 8.6 mos. Median PFS for pts with low NLR was 3.15 mos (95%CI 2.94-3.35) vs 2.9mos (95%CI 2.56-3.41) in pts with high NLR (P¼0.037). Median OS for patients with low NLR was 9.49 mos (95% CI 6.71-12.27) vs 8.54 mos in pts with high NLR (95% CI 6.82- 10.25) (P¼0.035). Pts with low SIRI had an increased PFS of 3.2 mos (95% CI 2.67- 3.76) and OS of 11.20 mos ( 95% CI 8.57-13.83) vs PFS of 2.9 mos (95%CI 2.6-3.2) and OS of 7.62 mos (95% CI 5.8-9.4 ) in pts with high SIRI, (P¼0.018 for PFS and 0.017 for OS). In OS and PFS, MVA adjusted for GPC and G3 neutropenia, NLR and SIRI were not independent prognostic factors. However, GPC and G3 neutropenia were independent prognostic factors for OS (HR 0.55; 95% CI 0.3-0.8; P¼0.003 and HR 0.4; 95% CI 0.3-0.7; P¼0.001, respectively.). Conclusions: Pts with low NLR or SIRI showed the best PFS and OS outcomes. Thus, these two blood-based tumour inflammatory markers could be useful for stratification of pts with stage IV CRC receiving TFT.
CitationAlchawaf A, Dawood M, Al-Ani M, Ho A, Ferrera A, Saunders M, et al. 463P The prognostic role of tumour inflammation markers in patients (pts) with colorectal cancer (CRC) treated with trifluridine/tipiuracil hydrochloride: Real-world data (RWD) from Greater Manchester. Annals of Oncology. 2020;31:S438-S.
JournalAnnals of Oncology
TypeMeetings and Proceedings