Cargando…

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

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...

Descripción completa

Detalles Bibliográficos
Autores principales: Liposits, Gabor, Skuladottir, Halla, Ryg, Jesper, Winther, Stine Brændegaard, Möller, Sören, Hofsli, Eva, Shah, Carl-Henrik, Poulsen, Laurids Østergaard, Berglund, Åke, Qvortrup, Camilla, Osterlund, Pia, Johansen, Julia S., Glimelius, Bengt, Sorbye, Halfdan, Pfeiffer, Per
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9571053/
https://www.ncbi.nlm.nih.gov/pubmed/36233472
http://dx.doi.org/10.3390/jcm11195603
_version_ 1784810266266959872
author Liposits, Gabor
Skuladottir, Halla
Ryg, Jesper
Winther, Stine Brændegaard
Möller, Sören
Hofsli, Eva
Shah, Carl-Henrik
Poulsen, Laurids Østergaard
Berglund, Åke
Qvortrup, Camilla
Osterlund, Pia
Johansen, Julia S.
Glimelius, Bengt
Sorbye, Halfdan
Pfeiffer, Per
author_facet Liposits, Gabor
Skuladottir, Halla
Ryg, Jesper
Winther, Stine Brændegaard
Möller, Sören
Hofsli, Eva
Shah, Carl-Henrik
Poulsen, Laurids Østergaard
Berglund, Åke
Qvortrup, Camilla
Osterlund, Pia
Johansen, Julia S.
Glimelius, Bengt
Sorbye, Halfdan
Pfeiffer, Per
author_sort Liposits, Gabor
collection PubMed
description 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.
format Online
Article
Text
id pubmed-9571053
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-95710532022-10-17 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 Liposits, Gabor Skuladottir, Halla Ryg, Jesper Winther, Stine Brændegaard Möller, Sören Hofsli, Eva Shah, Carl-Henrik Poulsen, Laurids Østergaard Berglund, Åke Qvortrup, Camilla Osterlund, Pia Johansen, Julia S. Glimelius, Bengt Sorbye, Halfdan Pfeiffer, Per J Clin Med Article 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. MDPI 2022-09-23 /pmc/articles/PMC9571053/ /pubmed/36233472 http://dx.doi.org/10.3390/jcm11195603 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
Liposits, Gabor
Skuladottir, Halla
Ryg, Jesper
Winther, Stine Brændegaard
Möller, Sören
Hofsli, Eva
Shah, Carl-Henrik
Poulsen, Laurids Østergaard
Berglund, Åke
Qvortrup, Camilla
Osterlund, Pia
Johansen, Julia S.
Glimelius, Bengt
Sorbye, Halfdan
Pfeiffer, Per
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
title 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_short 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
title_sort 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
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9571053/
https://www.ncbi.nlm.nih.gov/pubmed/36233472
http://dx.doi.org/10.3390/jcm11195603
work_keys_str_mv AT lipositsgabor theprognosticvalueofpretreatmentcirculatingbiomarkersofsystemicinflammationcrpdnlrykl40andil6invulnerableolderpatientswithmetastaticcolorectalcancerreceivingpalliativechemotherapytherandomizednordic9study
AT skuladottirhalla theprognosticvalueofpretreatmentcirculatingbiomarkersofsystemicinflammationcrpdnlrykl40andil6invulnerableolderpatientswithmetastaticcolorectalcancerreceivingpalliativechemotherapytherandomizednordic9study
AT rygjesper theprognosticvalueofpretreatmentcirculatingbiomarkersofsystemicinflammationcrpdnlrykl40andil6invulnerableolderpatientswithmetastaticcolorectalcancerreceivingpalliativechemotherapytherandomizednordic9study
AT wintherstinebrændegaard theprognosticvalueofpretreatmentcirculatingbiomarkersofsystemicinflammationcrpdnlrykl40andil6invulnerableolderpatientswithmetastaticcolorectalcancerreceivingpalliativechemotherapytherandomizednordic9study
AT mollersoren theprognosticvalueofpretreatmentcirculatingbiomarkersofsystemicinflammationcrpdnlrykl40andil6invulnerableolderpatientswithmetastaticcolorectalcancerreceivingpalliativechemotherapytherandomizednordic9study
AT hofslieva theprognosticvalueofpretreatmentcirculatingbiomarkersofsystemicinflammationcrpdnlrykl40andil6invulnerableolderpatientswithmetastaticcolorectalcancerreceivingpalliativechemotherapytherandomizednordic9study
AT shahcarlhenrik theprognosticvalueofpretreatmentcirculatingbiomarkersofsystemicinflammationcrpdnlrykl40andil6invulnerableolderpatientswithmetastaticcolorectalcancerreceivingpalliativechemotherapytherandomizednordic9study
AT poulsenlauridsøstergaard theprognosticvalueofpretreatmentcirculatingbiomarkersofsystemicinflammationcrpdnlrykl40andil6invulnerableolderpatientswithmetastaticcolorectalcancerreceivingpalliativechemotherapytherandomizednordic9study
AT berglundake theprognosticvalueofpretreatmentcirculatingbiomarkersofsystemicinflammationcrpdnlrykl40andil6invulnerableolderpatientswithmetastaticcolorectalcancerreceivingpalliativechemotherapytherandomizednordic9study
AT qvortrupcamilla theprognosticvalueofpretreatmentcirculatingbiomarkersofsystemicinflammationcrpdnlrykl40andil6invulnerableolderpatientswithmetastaticcolorectalcancerreceivingpalliativechemotherapytherandomizednordic9study
AT osterlundpia theprognosticvalueofpretreatmentcirculatingbiomarkersofsystemicinflammationcrpdnlrykl40andil6invulnerableolderpatientswithmetastaticcolorectalcancerreceivingpalliativechemotherapytherandomizednordic9study
AT johansenjulias theprognosticvalueofpretreatmentcirculatingbiomarkersofsystemicinflammationcrpdnlrykl40andil6invulnerableolderpatientswithmetastaticcolorectalcancerreceivingpalliativechemotherapytherandomizednordic9study
AT glimeliusbengt theprognosticvalueofpretreatmentcirculatingbiomarkersofsystemicinflammationcrpdnlrykl40andil6invulnerableolderpatientswithmetastaticcolorectalcancerreceivingpalliativechemotherapytherandomizednordic9study
AT sorbyehalfdan theprognosticvalueofpretreatmentcirculatingbiomarkersofsystemicinflammationcrpdnlrykl40andil6invulnerableolderpatientswithmetastaticcolorectalcancerreceivingpalliativechemotherapytherandomizednordic9study
AT pfeifferper theprognosticvalueofpretreatmentcirculatingbiomarkersofsystemicinflammationcrpdnlrykl40andil6invulnerableolderpatientswithmetastaticcolorectalcancerreceivingpalliativechemotherapytherandomizednordic9study
AT lipositsgabor prognosticvalueofpretreatmentcirculatingbiomarkersofsystemicinflammationcrpdnlrykl40andil6invulnerableolderpatientswithmetastaticcolorectalcancerreceivingpalliativechemotherapytherandomizednordic9study
AT skuladottirhalla prognosticvalueofpretreatmentcirculatingbiomarkersofsystemicinflammationcrpdnlrykl40andil6invulnerableolderpatientswithmetastaticcolorectalcancerreceivingpalliativechemotherapytherandomizednordic9study
AT rygjesper prognosticvalueofpretreatmentcirculatingbiomarkersofsystemicinflammationcrpdnlrykl40andil6invulnerableolderpatientswithmetastaticcolorectalcancerreceivingpalliativechemotherapytherandomizednordic9study
AT wintherstinebrændegaard prognosticvalueofpretreatmentcirculatingbiomarkersofsystemicinflammationcrpdnlrykl40andil6invulnerableolderpatientswithmetastaticcolorectalcancerreceivingpalliativechemotherapytherandomizednordic9study
AT mollersoren prognosticvalueofpretreatmentcirculatingbiomarkersofsystemicinflammationcrpdnlrykl40andil6invulnerableolderpatientswithmetastaticcolorectalcancerreceivingpalliativechemotherapytherandomizednordic9study
AT hofslieva prognosticvalueofpretreatmentcirculatingbiomarkersofsystemicinflammationcrpdnlrykl40andil6invulnerableolderpatientswithmetastaticcolorectalcancerreceivingpalliativechemotherapytherandomizednordic9study
AT shahcarlhenrik prognosticvalueofpretreatmentcirculatingbiomarkersofsystemicinflammationcrpdnlrykl40andil6invulnerableolderpatientswithmetastaticcolorectalcancerreceivingpalliativechemotherapytherandomizednordic9study
AT poulsenlauridsøstergaard prognosticvalueofpretreatmentcirculatingbiomarkersofsystemicinflammationcrpdnlrykl40andil6invulnerableolderpatientswithmetastaticcolorectalcancerreceivingpalliativechemotherapytherandomizednordic9study
AT berglundake prognosticvalueofpretreatmentcirculatingbiomarkersofsystemicinflammationcrpdnlrykl40andil6invulnerableolderpatientswithmetastaticcolorectalcancerreceivingpalliativechemotherapytherandomizednordic9study
AT qvortrupcamilla prognosticvalueofpretreatmentcirculatingbiomarkersofsystemicinflammationcrpdnlrykl40andil6invulnerableolderpatientswithmetastaticcolorectalcancerreceivingpalliativechemotherapytherandomizednordic9study
AT osterlundpia prognosticvalueofpretreatmentcirculatingbiomarkersofsystemicinflammationcrpdnlrykl40andil6invulnerableolderpatientswithmetastaticcolorectalcancerreceivingpalliativechemotherapytherandomizednordic9study
AT johansenjulias prognosticvalueofpretreatmentcirculatingbiomarkersofsystemicinflammationcrpdnlrykl40andil6invulnerableolderpatientswithmetastaticcolorectalcancerreceivingpalliativechemotherapytherandomizednordic9study
AT glimeliusbengt prognosticvalueofpretreatmentcirculatingbiomarkersofsystemicinflammationcrpdnlrykl40andil6invulnerableolderpatientswithmetastaticcolorectalcancerreceivingpalliativechemotherapytherandomizednordic9study
AT sorbyehalfdan prognosticvalueofpretreatmentcirculatingbiomarkersofsystemicinflammationcrpdnlrykl40andil6invulnerableolderpatientswithmetastaticcolorectalcancerreceivingpalliativechemotherapytherandomizednordic9study
AT pfeifferper prognosticvalueofpretreatmentcirculatingbiomarkersofsystemicinflammationcrpdnlrykl40andil6invulnerableolderpatientswithmetastaticcolorectalcancerreceivingpalliativechemotherapytherandomizednordic9study