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Inflammation-based scores as predictors of treatment response in advanced adrenocortical carcinoma

Treatment for advanced adrenocortical carcinoma (ACC) consists of mitotane alone or combined with etoposide, doxorubicin, and cisplatin (EDP). Although both therapies are widely used, markers of response are still lacking. Since inflammation-based scores have been proposed as prognostic factors in A...

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Autores principales: Mangone, Alessandra, Altieri, Barbara, Detomas, Mario, Prete, Alessandro, Abbas, Haider, Asia, Miriam, Elhassan, Yasir S, Mantovani, Giovanna, Ronchi, Cristina L
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Bioscientifica Ltd 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10083578/
https://www.ncbi.nlm.nih.gov/pubmed/36715606
http://dx.doi.org/10.1530/ERC-22-0372
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author Mangone, Alessandra
Altieri, Barbara
Detomas, Mario
Prete, Alessandro
Abbas, Haider
Asia, Miriam
Elhassan, Yasir S
Mantovani, Giovanna
Ronchi, Cristina L
author_facet Mangone, Alessandra
Altieri, Barbara
Detomas, Mario
Prete, Alessandro
Abbas, Haider
Asia, Miriam
Elhassan, Yasir S
Mantovani, Giovanna
Ronchi, Cristina L
author_sort Mangone, Alessandra
collection PubMed
description Treatment for advanced adrenocortical carcinoma (ACC) consists of mitotane alone or combined with etoposide, doxorubicin, and cisplatin (EDP). Although both therapies are widely used, markers of response are still lacking. Since inflammation-based scores have been proposed as prognostic factors in ACC, we aimed to investigate their role in predicting the response to first-line chemotherapy. We performed a retrospective analysis of patients with advanced ACC treated with mitotane monotherapy or EDP ± mitotane. Clinical parameters (tumour stage at diagnosis, resection status, Ki67, time from diagnosis to treatment start, performance status, plasma mitotane levels, time in mitotane target ≥ 80%, clinically overt cortisol hypersecretion), and pretreatment inflammation-based scores (neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio, derived neutrophil-to-lymphocyte ratio) were investigated. The primary endpoints were overall survival (OS) and time-to-progression (TTP) from treatment initiation, the secondary endpoint was the best objective response to treatment. We included 90 patients (59% = women, median age = 51 years) treated with mitotane monotherapy (n = 40) or EDP ± mitotane (n = 50). In the mitotane monotherapy cohort, NLR ≥ 5 and PLR ≥ 190 predicted shorter OS (hazard ratio (HR): 145.83, 95% CI: 1.87–11,323.83; HR: 165.50, 95% CI: 1.76–15,538.04, respectively), remaining significant at multivariable analysis including clinical variables. NLR was also associated with shorter TTP (HR: 2.58, 95% CI: 1.28–5.20), but only at univariable analysis. Patients with NLR ≥ 5 showed a worse treatment response than those with NLR < 5 (P = 0.040). In the EDP ± mitotane cohort, NLR ≥ 5 predicted shorter OS (HR: 2.52, 95% CI: 1.30–4.88) and TTP (HR: 1.95, 95% CI: 1.04–3.66) at univariable analysis. In conclusion, inflammation-based scores, calculated from routinely measured parameters, may help predict response to chemotherapy in advanced ACC.
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spelling pubmed-100835782023-04-11 Inflammation-based scores as predictors of treatment response in advanced adrenocortical carcinoma Mangone, Alessandra Altieri, Barbara Detomas, Mario Prete, Alessandro Abbas, Haider Asia, Miriam Elhassan, Yasir S Mantovani, Giovanna Ronchi, Cristina L Endocr Relat Cancer Research Treatment for advanced adrenocortical carcinoma (ACC) consists of mitotane alone or combined with etoposide, doxorubicin, and cisplatin (EDP). Although both therapies are widely used, markers of response are still lacking. Since inflammation-based scores have been proposed as prognostic factors in ACC, we aimed to investigate their role in predicting the response to first-line chemotherapy. We performed a retrospective analysis of patients with advanced ACC treated with mitotane monotherapy or EDP ± mitotane. Clinical parameters (tumour stage at diagnosis, resection status, Ki67, time from diagnosis to treatment start, performance status, plasma mitotane levels, time in mitotane target ≥ 80%, clinically overt cortisol hypersecretion), and pretreatment inflammation-based scores (neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio, derived neutrophil-to-lymphocyte ratio) were investigated. The primary endpoints were overall survival (OS) and time-to-progression (TTP) from treatment initiation, the secondary endpoint was the best objective response to treatment. We included 90 patients (59% = women, median age = 51 years) treated with mitotane monotherapy (n = 40) or EDP ± mitotane (n = 50). In the mitotane monotherapy cohort, NLR ≥ 5 and PLR ≥ 190 predicted shorter OS (hazard ratio (HR): 145.83, 95% CI: 1.87–11,323.83; HR: 165.50, 95% CI: 1.76–15,538.04, respectively), remaining significant at multivariable analysis including clinical variables. NLR was also associated with shorter TTP (HR: 2.58, 95% CI: 1.28–5.20), but only at univariable analysis. Patients with NLR ≥ 5 showed a worse treatment response than those with NLR < 5 (P = 0.040). In the EDP ± mitotane cohort, NLR ≥ 5 predicted shorter OS (HR: 2.52, 95% CI: 1.30–4.88) and TTP (HR: 1.95, 95% CI: 1.04–3.66) at univariable analysis. In conclusion, inflammation-based scores, calculated from routinely measured parameters, may help predict response to chemotherapy in advanced ACC. Bioscientifica Ltd 2023-01-30 /pmc/articles/PMC10083578/ /pubmed/36715606 http://dx.doi.org/10.1530/ERC-22-0372 Text en © the author(s) https://creativecommons.org/licenses/by/4.0/This work is licensed under a Creative Commons Attribution 4.0 International License. (https://creativecommons.org/licenses/by/4.0/)
spellingShingle Research
Mangone, Alessandra
Altieri, Barbara
Detomas, Mario
Prete, Alessandro
Abbas, Haider
Asia, Miriam
Elhassan, Yasir S
Mantovani, Giovanna
Ronchi, Cristina L
Inflammation-based scores as predictors of treatment response in advanced adrenocortical carcinoma
title Inflammation-based scores as predictors of treatment response in advanced adrenocortical carcinoma
title_full Inflammation-based scores as predictors of treatment response in advanced adrenocortical carcinoma
title_fullStr Inflammation-based scores as predictors of treatment response in advanced adrenocortical carcinoma
title_full_unstemmed Inflammation-based scores as predictors of treatment response in advanced adrenocortical carcinoma
title_short Inflammation-based scores as predictors of treatment response in advanced adrenocortical carcinoma
title_sort inflammation-based scores as predictors of treatment response in advanced adrenocortical carcinoma
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10083578/
https://www.ncbi.nlm.nih.gov/pubmed/36715606
http://dx.doi.org/10.1530/ERC-22-0372
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