Cargando…

C-Reactive Protein as Predictive Biomarker for Response to Chemoradiotherapy in Patients with Locally Advanced Rectal Cancer: A Retrospective Study

SIMPLE SUMMARY: Most patients with locally advanced rectal cancer present resistance or a moderate response to neoadjuvant chemoradiotherapy (nCRT), which is considered the standard of care. To select patients who could benefit from nCRT, while avoiding unnecessary treatment-induced toxicity and sur...

Descripción completa

Detalles Bibliográficos
Autores principales: Aires, Fátima, Rodrigues, Darlene, Lamas, María Piñeiro, Herdeiro, Maria Teresa, Figueiras, Adolfo, Oliveira, Maria José, Marques, Margarida, Pinto, Ana Teresa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8833484/
https://www.ncbi.nlm.nih.gov/pubmed/35158759
http://dx.doi.org/10.3390/cancers14030491
_version_ 1784648954402570240
author Aires, Fátima
Rodrigues, Darlene
Lamas, María Piñeiro
Herdeiro, Maria Teresa
Figueiras, Adolfo
Oliveira, Maria José
Marques, Margarida
Pinto, Ana Teresa
author_facet Aires, Fátima
Rodrigues, Darlene
Lamas, María Piñeiro
Herdeiro, Maria Teresa
Figueiras, Adolfo
Oliveira, Maria José
Marques, Margarida
Pinto, Ana Teresa
author_sort Aires, Fátima
collection PubMed
description SIMPLE SUMMARY: Most patients with locally advanced rectal cancer present resistance or a moderate response to neoadjuvant chemoradiotherapy (nCRT), which is considered the standard of care. To select patients who could benefit from nCRT, while avoiding unnecessary treatment-induced toxicity and surgery-associated morbidity, it is urgent to find biomarkers of response to chemoradiotherapy. Therefore, the aim of our retrospective study was to assess the potential of classical blood analytes collected before chemoradiotherapy as biomarkers of response to treatment and prognostics in locally advanced rectal cancer. Our results identified C-reactive protein ≤3.5 as a strong independent predictor of response to treatment and an independent predictor of disease-free survival (DFS) and overall survival (OS). Additionally, platelets were found to be independent predictors of DFS and OS and hemoglobin of DFS. These data might contribute to the personalization of rectal cancer treatment by guiding clinicians in decision-making regarding the best treatment strategy for each patient. ABSTRACT: The standard of care for the treatment of locally advanced rectal cancer is neoadjuvant chemoradiotherapy (nCRT) followed by surgery, but complete response rates are reduced. To find predictive biomarkers of response to therapy, we conducted a retrospective study evaluating blood biomarkers before nCRT. Hemoglobin (Hg), C-reactive protein (CRP), platelets, carcinoembryonic antigen, carbohydrate antigen 19.9 levels, and neutrophil/lymphocyte ratio were obtained from 171 rectal cancer patients before nCRT. Patients were classified as responders (Ryan 0–1; ycT0N0), 59.6% (n = 102), or nonresponders (Ryan 2–3), 40.3% (n = 69), in accordance with the Ryan classification. A logistic regression using prognostic pretreatment factors identified CRP ≤ 3.5 (OR = 0.05; 95%CI: 0.01–0.21) as a strong independent predictor of response to treatment. Multivariate analysis showed that CRP was an independent predictor of disease-free survival (DFS) (HR = 5.48; 95%CI: 1.54–19.48) and overall survival (HR = 6.10; 95%CI 1.27–29.33) in patients treated with nCRT. Platelets were an independent predictor of DFS (HR = 3.068; 95%CI: 1.29–7.30) and OS (HR= 4.65; 95%CI: 1.66–13.05) and Hg was revealed to be an independent predictor of DFS (HR = 0.37; 95%CI: 0.15–0.90) in rectal cancer patients treated with nCRT. The lower expression of CRP is independently associated with an improved response to nCRT, DFS, and OS.
format Online
Article
Text
id pubmed-8833484
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-88334842022-02-12 C-Reactive Protein as Predictive Biomarker for Response to Chemoradiotherapy in Patients with Locally Advanced Rectal Cancer: A Retrospective Study Aires, Fátima Rodrigues, Darlene Lamas, María Piñeiro Herdeiro, Maria Teresa Figueiras, Adolfo Oliveira, Maria José Marques, Margarida Pinto, Ana Teresa Cancers (Basel) Article SIMPLE SUMMARY: Most patients with locally advanced rectal cancer present resistance or a moderate response to neoadjuvant chemoradiotherapy (nCRT), which is considered the standard of care. To select patients who could benefit from nCRT, while avoiding unnecessary treatment-induced toxicity and surgery-associated morbidity, it is urgent to find biomarkers of response to chemoradiotherapy. Therefore, the aim of our retrospective study was to assess the potential of classical blood analytes collected before chemoradiotherapy as biomarkers of response to treatment and prognostics in locally advanced rectal cancer. Our results identified C-reactive protein ≤3.5 as a strong independent predictor of response to treatment and an independent predictor of disease-free survival (DFS) and overall survival (OS). Additionally, platelets were found to be independent predictors of DFS and OS and hemoglobin of DFS. These data might contribute to the personalization of rectal cancer treatment by guiding clinicians in decision-making regarding the best treatment strategy for each patient. ABSTRACT: The standard of care for the treatment of locally advanced rectal cancer is neoadjuvant chemoradiotherapy (nCRT) followed by surgery, but complete response rates are reduced. To find predictive biomarkers of response to therapy, we conducted a retrospective study evaluating blood biomarkers before nCRT. Hemoglobin (Hg), C-reactive protein (CRP), platelets, carcinoembryonic antigen, carbohydrate antigen 19.9 levels, and neutrophil/lymphocyte ratio were obtained from 171 rectal cancer patients before nCRT. Patients were classified as responders (Ryan 0–1; ycT0N0), 59.6% (n = 102), or nonresponders (Ryan 2–3), 40.3% (n = 69), in accordance with the Ryan classification. A logistic regression using prognostic pretreatment factors identified CRP ≤ 3.5 (OR = 0.05; 95%CI: 0.01–0.21) as a strong independent predictor of response to treatment. Multivariate analysis showed that CRP was an independent predictor of disease-free survival (DFS) (HR = 5.48; 95%CI: 1.54–19.48) and overall survival (HR = 6.10; 95%CI 1.27–29.33) in patients treated with nCRT. Platelets were an independent predictor of DFS (HR = 3.068; 95%CI: 1.29–7.30) and OS (HR= 4.65; 95%CI: 1.66–13.05) and Hg was revealed to be an independent predictor of DFS (HR = 0.37; 95%CI: 0.15–0.90) in rectal cancer patients treated with nCRT. The lower expression of CRP is independently associated with an improved response to nCRT, DFS, and OS. MDPI 2022-01-19 /pmc/articles/PMC8833484/ /pubmed/35158759 http://dx.doi.org/10.3390/cancers14030491 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Aires, Fátima
Rodrigues, Darlene
Lamas, María Piñeiro
Herdeiro, Maria Teresa
Figueiras, Adolfo
Oliveira, Maria José
Marques, Margarida
Pinto, Ana Teresa
C-Reactive Protein as Predictive Biomarker for Response to Chemoradiotherapy in Patients with Locally Advanced Rectal Cancer: A Retrospective Study
title C-Reactive Protein as Predictive Biomarker for Response to Chemoradiotherapy in Patients with Locally Advanced Rectal Cancer: A Retrospective Study
title_full C-Reactive Protein as Predictive Biomarker for Response to Chemoradiotherapy in Patients with Locally Advanced Rectal Cancer: A Retrospective Study
title_fullStr C-Reactive Protein as Predictive Biomarker for Response to Chemoradiotherapy in Patients with Locally Advanced Rectal Cancer: A Retrospective Study
title_full_unstemmed C-Reactive Protein as Predictive Biomarker for Response to Chemoradiotherapy in Patients with Locally Advanced Rectal Cancer: A Retrospective Study
title_short C-Reactive Protein as Predictive Biomarker for Response to Chemoradiotherapy in Patients with Locally Advanced Rectal Cancer: A Retrospective Study
title_sort c-reactive protein as predictive biomarker for response to chemoradiotherapy in patients with locally advanced rectal cancer: a retrospective study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8833484/
https://www.ncbi.nlm.nih.gov/pubmed/35158759
http://dx.doi.org/10.3390/cancers14030491
work_keys_str_mv AT airesfatima creactiveproteinaspredictivebiomarkerforresponsetochemoradiotherapyinpatientswithlocallyadvancedrectalcanceraretrospectivestudy
AT rodriguesdarlene creactiveproteinaspredictivebiomarkerforresponsetochemoradiotherapyinpatientswithlocallyadvancedrectalcanceraretrospectivestudy
AT lamasmariapineiro creactiveproteinaspredictivebiomarkerforresponsetochemoradiotherapyinpatientswithlocallyadvancedrectalcanceraretrospectivestudy
AT herdeiromariateresa creactiveproteinaspredictivebiomarkerforresponsetochemoradiotherapyinpatientswithlocallyadvancedrectalcanceraretrospectivestudy
AT figueirasadolfo creactiveproteinaspredictivebiomarkerforresponsetochemoradiotherapyinpatientswithlocallyadvancedrectalcanceraretrospectivestudy
AT oliveiramariajose creactiveproteinaspredictivebiomarkerforresponsetochemoradiotherapyinpatientswithlocallyadvancedrectalcanceraretrospectivestudy
AT marquesmargarida creactiveproteinaspredictivebiomarkerforresponsetochemoradiotherapyinpatientswithlocallyadvancedrectalcanceraretrospectivestudy
AT pintoanateresa creactiveproteinaspredictivebiomarkerforresponsetochemoradiotherapyinpatientswithlocallyadvancedrectalcanceraretrospectivestudy