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Evaluation of the inflammation-based modified Glasgow Prognostic Score (mGPS) as a prognostic and predictive biomarker in patients with metastatic colorectal cancer receiving first-line chemotherapy: a post hoc analysis of the randomized phase III XELAVIRI trial (AIO KRK0110).
Boukovala, M; Modest, D P; Ricard, I; Fischer von Weikersthal, L; Decker, T; Vehling-Kaiser, U; Uhlig, J; Schenk, M; Freiberg-Richter, J; Peuser, B; Denzlinger, C; Peveling Genannt Reddemann, C; Graeven, U; Schuch, G; Schwaner, I; Heinrich, K; Neumann, J; Jung, A; Held, S; Stintzing, S; Heinemann, V; Michl, M.
Afiliación
  • Boukovala M; Department of Medicine III, University Hospital, LMU Munich, München; Comprehensive Cancer Center, University Hospital, LMU Munich, München.
  • Modest DP; Department of Hematology, Oncology, and Tumor Immunology (CCM), Charité-Universitaetsmedizin, Berlin; German Cancer Consortium (DKTK), German Cancer Research Centre (DKFZ), Heidelberg.
  • Ricard I; Comprehensive Cancer Center, University Hospital, LMU Munich, München.
  • Fischer von Weikersthal L; Gesundheitszentrum St. Marien, Amberg.
  • Decker T; Private Oncological Practice, Ravensburg.
  • Vehling-Kaiser U; Private Oncological Practice, Landshut.
  • Uhlig J; Private Oncological Practice, Naunhof.
  • Schenk M; Krankenhaus Barmherzige Brüder Regensburg, Regensburg.
  • Freiberg-Richter J; Private Oncological Practice, Dresden.
  • Peuser B; Onkologische Praxis am Diakonissenhaus, Leipzig.
  • Denzlinger C; Medical Clinic 3, Marienhospital, Stuttgart.
  • Peveling Genannt Reddemann C; MVZ RNR Leverkusen am Gesundheitspark, Leverkusen.
  • Graeven U; Kliniken Maria Hilf GmbH, Mönchengladbach.
  • Schuch G; Hämatologisch-Onkologische Praxis Altona, Hamburg.
  • Schwaner I; Onkologische Schwerpunktpraxis Kurfürstendamm, Berlin.
  • Heinrich K; Department of Medicine III, University Hospital, LMU Munich, München; Comprehensive Cancer Center, University Hospital, LMU Munich, München.
  • Neumann J; Institute of Pathology, Ludwig-Maximilians-University of Munich.
  • Jung A; German Cancer Consortium (DKTK), German Cancer Research Centre (DKFZ), Heidelberg; Institute of Pathology, Ludwig-Maximilians-University of Munich.
  • Held S; ClinAssess GmbH, Leverkusen, Germany.
  • Stintzing S; Department of Hematology, Oncology, and Tumor Immunology (CCM), Charité-Universitaetsmedizin, Berlin; German Cancer Consortium (DKTK), German Cancer Research Centre (DKFZ), Heidelberg.
  • Heinemann V; Department of Medicine III, University Hospital, LMU Munich, München; Comprehensive Cancer Center, University Hospital, LMU Munich, München; German Cancer Consortium (DKTK), German Cancer Research Centre (DKFZ), Heidelberg.
  • Michl M; Department of Medicine III, University Hospital, LMU Munich, München; Comprehensive Cancer Center, University Hospital, LMU Munich, München. Electronic address: Marlies.Michl@onkologie-muenchen-solln.de.
ESMO Open ; 9(5): 103374, 2024 May.
Article en En | MEDLINE | ID: mdl-38744100
ABSTRACT

BACKGROUND:

The inflammation-based modified Glasgow Prognostic Score (mGPS) combines serum levels of C-reactive protein and albumin and was shown to predict survival in advanced cancer. We aimed to elucidate the prognostic impact of mGPS on survival as well as its predictive value when combined with gender in unselected metastatic colorectal cancer (mCRC) patients receiving first-line chemotherapy in the randomized phase III XELAVIRI trial. PATIENTS AND

METHODS:

In XELAVIRI, mCRC patients were treated with either fluoropyrimidine/bevacizumab followed by additional irinotecan at first progression (sequential treatment arm; Arm A) or upfront combination of fluoropyrimidine/bevacizumab/irinotecan (intensive treatment arm; Arm B). In the present post hoc analysis, survival was evaluated with respect to the assorted mGPS categories 0, 1 or 2. Interaction between mGPS and gender was analyzed.

RESULTS:

Out of 421 mCRC patients treated in XELAVIRI, 362 [119 women (32.9%) and 243 men (67.1%)] were assessable. For the entire study population a significant association between mGPS and overall survival (OS) was observed [mGPS = 0 median 28.9 months, 95% confidence interval (CI) 25.9-33.6 months; mGPS = 1 median 21.4 months, 95% CI 17.6-26.1 months; mGPS = 2 median 16.8 months, 95% CI 14.3-21.2 months; P < 0.00001]. Similar results were found when comparing progression-free survival between groups. The effect of mGPS on survival did not depend on the applied treatment regimen (P = 0.21). In female patients, a trend towards longer OS was observed in Arm A versus Arm B, with this effect being clearly more pronounced in the mGPS cohort 0 (41.6 versus 25.5 months; P = 0.056). By contrast, median OS was longer in male patients with an mGPS of 1-2 treated in Arm B versus Arm A (20.8 versus 17.4 months; P = 0.022).

CONCLUSION:

We demonstrate the role of mGPS as an independent predictor of OS regardless of the treatment regimen in mCRC patients receiving first-line treatment. mGPS may help identify gender-specific subgroups that benefit more or less from upfront intensive therapy.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Colorrectales / Protocolos de Quimioterapia Combinada Antineoplásica Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: ESMO Open Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Colorrectales / Protocolos de Quimioterapia Combinada Antineoplásica Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: ESMO Open Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido