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Boukovala M, Modest DP, 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. 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). ESMO Open 2024; 9:103374. [PMID: 38744100 PMCID: PMC11108861 DOI: 10.1016/j.esmoop.2024.103374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/29/2024] [Accepted: 03/28/2024] [Indexed: 05/16/2024] Open
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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Affiliation(s)
- M Boukovala
- Department of Medicine III, University Hospital, LMU Munich, München; Comprehensive Cancer Center, University Hospital, LMU Munich, München
| | - D P Modest
- Department of Hematology, Oncology, and Tumor Immunology (CCM), Charité-Universitaetsmedizin, Berlin; German Cancer Consortium (DKTK), German Cancer Research Centre (DKFZ), Heidelberg
| | - I Ricard
- Comprehensive Cancer Center, University Hospital, LMU Munich, München
| | | | - T Decker
- Private Oncological Practice, Ravensburg
| | | | - J Uhlig
- Private Oncological Practice, Naunhof
| | - M Schenk
- Krankenhaus Barmherzige Brüder Regensburg, Regensburg
| | | | - B Peuser
- Onkologische Praxis am Diakonissenhaus, Leipzig
| | | | | | - U Graeven
- Kliniken Maria Hilf GmbH, Mönchengladbach
| | - G Schuch
- Hämatologisch-Onkologische Praxis Altona, Hamburg
| | - I Schwaner
- Onkologische Schwerpunktpraxis Kurfürstendamm, Berlin
| | - K Heinrich
- Department of Medicine III, University Hospital, LMU Munich, München; Comprehensive Cancer Center, University Hospital, LMU Munich, München
| | - J Neumann
- Institute of Pathology, Ludwig-Maximilians-University of Munich
| | - A Jung
- German Cancer Consortium (DKTK), German Cancer Research Centre (DKFZ), Heidelberg; Institute of Pathology, Ludwig-Maximilians-University of Munich
| | - S Held
- ClinAssess GmbH, Leverkusen, Germany
| | - S Stintzing
- Department of Hematology, Oncology, and Tumor Immunology (CCM), Charité-Universitaetsmedizin, Berlin; German Cancer Consortium (DKTK), German Cancer Research Centre (DKFZ), Heidelberg
| | - V Heinemann
- 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
| | - M Michl
- Department of Medicine III, University Hospital, LMU Munich, München; Comprehensive Cancer Center, University Hospital, LMU Munich, München.
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Igawa S, Yamamoto H, Yamada K, Akazawa Y, Manaka H, Yagami Y, Nakahara Y, Sato T, Mitsufuji H, Sasaki J, Naoki K. The Glasgow Prognostic Score Predicts Survival Outcomes in Patients with Extensive-Stage Small Cell Lung Cancer. Oncology 2023; 101:695-704. [PMID: 37494886 DOI: 10.1159/000532087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 07/14/2023] [Indexed: 07/28/2023]
Abstract
INTRODUCTION The Glasgow prognostic score (GPS) is an inflammation-related score based on C-reactive protein and albumin concentrations. Few studies have assessed the correlation between the GPS and the efficacy of chemotherapy in patients with extensive-stage small cell lung cancer (ES-SCLC). Therefore, this study aimed to evaluate the utility of the GPS in predicting the survival outcomes of patients with ES-SCLC. METHODS This retrospective study evaluated patients with ES-SCLC who had undergone chemotherapy between February 2008 and November 2021. GPS values were evaluated before the initiation of first-line chemotherapy. The Kaplan-Meier method and Cox proportional hazards models were used to assess progression-free survival (PFS) and overall survival (OS). RESULTS The GPS values of the 113 patients were zero (54 patients, 48%), 1 (37 patients, 33%), and 2 (22 patients, 19%). The median follow-up duration was 10.7 months. Median PFS was 6.2, 5.6, and 3.8 months in the GPS 0, 1, and 2 groups, respectively, suggesting that the GPS zero group had a significantly more favorable PFS than the GPS 2 group (p < 0.001). Median OS was 17.1, 9.4, and 5.6 months in the GPS 0, 1, and 2 groups, respectively, suggesting that the GPS zero group had a significantly more favorable OS than the GPS 2 group (p = 0.001). Multivariate analysis confirmed that a GPS of 2 independently predicted unfavorable PFS (hazard ratio [HR], 2.89; 95% confidence interval [CI]: 1.68-4.88; p < 0.001) and OS (HR, 3.49 [95% CI: 1.83-6.63], p < 0.001). CONCLUSION The study's findings suggest that the GPS can predict the survival outcomes of patients with ES-SCLC who have undergone chemotherapy. The GPS is an easy-to-calculate biomarker and would be ideal for routine use in clinical settings.
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Affiliation(s)
- Satoshi Igawa
- Department of Respiratory Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Hiroki Yamamoto
- Department of Respiratory Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Kaori Yamada
- Department of Respiratory Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Yuki Akazawa
- Department of Respiratory Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Hiroya Manaka
- Department of Respiratory Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Yuri Yagami
- Department of Respiratory Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Yoshiro Nakahara
- Department of Respiratory Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Takashi Sato
- Department of Respiratory Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | | | - Jiichiro Sasaki
- Research and Development Center for New Medical Frontiers, Kitasato University School of Medicine, Sagamihara, Japan
| | - Katsuhiko Naoki
- Department of Respiratory Medicine, Kitasato University School of Medicine, Sagamihara, Japan
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Akazawa Y, Igawa S, Yamada K, Yamamoto H, Yagami Y, Kaizuka N, Manaka H, Kasajima M, Nakahara Y, Sato T, Mitsufuji H, Yokoba M, Kubota M, Sasaki J, Naoki K. The Glasgow Prognostic Score Predicts Survival in Patients with Advanced Non-Small Cell Lung Cancer Harboring Sensitive Epidermal Growth Factor Receptor Mutations Who Are Treated with Epidermal Growth Factor Receptor-Tyrosine Kinase Inhibitors. Oncology 2023; 101:685-694. [PMID: 37166346 PMCID: PMC10614514 DOI: 10.1159/000530809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 04/18/2023] [Indexed: 05/12/2023]
Abstract
INTRODUCTION Epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) are the standard first-line treatment for advanced non-small cell lung cancer (NSCLC) with sensitive EGFR mutations. The Glasgow prognostic score (GPS) is an inflammation-assessing score based on C-reactive protein and albumin concentrations. Information regarding the association between the GPS and EGFR-TKI treatment effectiveness is limited; hence, we investigated whether the GPS can predict the response of NSCLC to EGFR-TKIs. METHODS We evaluated 340 patients with NSCLC harboring sensitive EGFR mutations who received EGFR-TKI monotherapy between March 2009 and July 2021. The Kaplan-Meier method and Cox proportional hazards models were used to assess progression-free survival (PFS) and overall survival (OS). RESULTS After a median follow-up of 26.6 months, patients with a GPS of 0, 1, and 2 had PFS of 15.7, 10.0, and 6.3 months, respectively, and OS of 40.1, 25.8, and 14.4 months, respectively; patients with a GPS of 0 had significantly better PFS and OS than those with a GPS of 1 (p = 0.03, p = 0.001, respectively) or 2 (p < 0.001, p < 0.001, respectively). Multivariate analysis identified poor performance status, stage 4 at diagnosis, type of EGFR-TKI (gefitinib/erlotinib vs. afatinib), and GPS = 2 as predictors of a short PFS. Meanwhile, poor performance status, gefitinib/erlotinib administration, and GPS = 2 were predictors of a short OS. CONCLUSION The GPS predicted the survival of NSCLC patients harboring sensitive EGFR mutations who were undergoing EGFR-TKI treatment. The GPS might be ideal for routine use in clinical practice, given that it is an easily calculated parameter.
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Affiliation(s)
- Yuki Akazawa
- Department of Respiratory Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Satoshi Igawa
- Department of Respiratory Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Kaori Yamada
- Department of Respiratory Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Hiroki Yamamoto
- Department of Respiratory Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Yuri Yagami
- Department of Respiratory Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Nobuki Kaizuka
- Department of Respiratory Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Hiroya Manaka
- Department of Respiratory Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Masashi Kasajima
- Department of Respiratory Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Yoshiro Nakahara
- Department of Respiratory Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Takashi Sato
- Department of Respiratory Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | | | - Masanori Yokoba
- School of Allied Health Sciences, Kitasato University, Sagamihara, Japan
| | - Masaru Kubota
- School of Allied Health Sciences, Kitasato University, Sagamihara, Japan
| | - Jiichiro Sasaki
- Research and Development Center for New Medical Frontiers, Kitasato University School of Medicine, Sagamihara, Japan
| | - Katsuhiko Naoki
- Department of Respiratory Medicine, Kitasato University School of Medicine, Sagamihara, Japan
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Kasajima M, Igawa S, Manaka H, Yamada K, Akazawa Y, Manabe H, Yagami Y, Yamamoto H, Ito H, Kaizuka N, Nakahara Y, Sato T, Mitshufuji H, Yokoba M, Kubota M, Sasaki J, Naoki K. The Glasgow Prognostic Score Predicts Outcomes of Pembrolizumab or Atezolizumab Monotherapy in Patients with Pretreated Non-Small Cell Lung Cancer. Oncology 2023; 101:69-76. [PMID: 36103811 PMCID: PMC9872847 DOI: 10.1159/000526964] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 09/02/2022] [Indexed: 01/27/2023]
Abstract
INTRODUCTION Predictors of the effectiveness of immune checkpoint inhibitor (ICI) monotherapy in previously treated patients with non-small cell lung cancer (NSCLC) remain ill-defined. We investigated whether the Glasgow prognostic score (GPS) could serve as such predictors. METHODS Eighty patients treated with pembrolizumab or atezolizumab monotherapy as second- or subsequent-line therapy for NSCLC were retrospectively reviewed, and the associations between GPS, body mass index (BMI), and each of progression-free survival (PFS) and overall survival (OS) were assessed. RESULTS The median follow-up period was 11.1 months. Patients with a BMI ≥20.4 kg/m2 had significantly longer PFS and OS (3.7 and 22.2 month, respectively) than did those with a BMI <20.4 kg/m2 (2.2 and 11.5 months, respectively). Patients with a GPS of 0 had a significantly longer PFS (6.6 months) than did those with a GPS of 1 (2.2 months, p = 0.002) and 2 (1.8 months, p = 0.029). Patients with a GPS of 0 also had a significantly longer OS (22.2 month) than did those with a GPS of 1 (9.2 months, p = 0.002) and 2 (4.7 months, p = 0.002). Notably, the GPS, BMI, and clinical stage were independent predictors of PFS, while the GPS and performance status were independent predictors of OS. The response rate of patients with a GPS of 0 was significantly higher than that of patients with a GPS of 1-2 (26.2% vs. 7.9%, p = 0.03). CONCLUSION The GPS is an independent predictor of PFS and OS in patients with NSCLC who received second- or subsequent-line pembrolizumab or atezolizumab monotherapy.
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Affiliation(s)
- Masashi Kasajima
- Department of Respiratory Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Satoshi Igawa
- Department of Respiratory Medicine, Kitasato University School of Medicine, Sagamihara, Japan,*Satoshi Igawa,
| | - Hiroya Manaka
- Department of Respiratory Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Kaori Yamada
- Department of Respiratory Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Yuki Akazawa
- Department of Respiratory Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Hideaki Manabe
- Department of Respiratory Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Yuri Yagami
- Department of Respiratory Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Hiroki Yamamoto
- Department of Respiratory Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Hiroki Ito
- Department of Respiratory Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Nobuki Kaizuka
- Department of Respiratory Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Yoshiro Nakahara
- Department of Respiratory Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Takashi Sato
- Department of Respiratory Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | | | - Masanori Yokoba
- School of Allied Health Sciences, Kitasato University, Sagamihara, Japan
| | - Masaru Kubota
- School of Allied Health Sciences, Kitasato University, Sagamihara, Japan
| | - Jiichiro Sasaki
- Research and Development Center for New Medical Frontiers, Kitasato University School of Medicine, Sagamihara, Japan
| | - Katsuhiko Naoki
- Department of Respiratory Medicine, Kitasato University School of Medicine, Sagamihara, Japan
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Boku S, Satake H, Ohta T, Mitani S, Kawakami K, Suzuki Y, Matsumoto T, Terazawa T, Yamazaki E, Hasegawa H, Ikoma T, Uemura M, Yamaguchi T, Naito A, Ishizuka Y, Kurokawa Y, Sakai D, Kawakami H, Shimokawa T, Tsujinaka T, Kato T, Satoh T, Kagawa Y. TRESBIEN (OGSG 2101): encorafenib, binimetinib and cetuximab for early recurrent stage II/III BRAF V600E-mutated colorectal cancer. Future Oncol 2022; 18:4153-4160. [PMID: 36475784 DOI: 10.2217/fon-2022-0949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The BRAF V600E mutation accounts for approximately 5% of colorectal cancer (CRC) cases and is an extremely poor prognostic factor. However, there are no clear recommendations regarding first-line therapy for patients with early recurrent BRAF V600E-mutated CRC, during or after adjuvant chemotherapy. Recently, a novel combination of encorafenib, binimetinib and cetuximab, showed a higher response rate than standard chemotherapy in patients with BRAF V600E-mutated CRC. Here we describe our plan for the TRESBIEN study (OGSG 2101), which is an open-label, multicenter, single-arm, phase II study designed to evaluate whether encorafenib, binimetinib and cetuximab are effective for patients with early recurrent BRAF V600E-mutated colorectal cancer, during or after adjuvant chemotherapy. The planned number of subjects is 25.
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Affiliation(s)
- Shogen Boku
- Cancer Treatment Center, Kansai Medical University Hospital, Hirakata, 573-1191, Japan
| | - Hironaga Satake
- Department of Medical Oncology, Kochi Medical School, Nankoku, 783-8505, Japan
| | - Takashi Ohta
- Department of Clinical Oncology, Kansai Rosai Hospital, Amagasaki, 660-8511, Japan
| | - Seiichiro Mitani
- Department of Medical Oncology, Faculty of Medicine, Kindai University, Osaka-Sayama, 589-8511, Japan
| | - Kentaro Kawakami
- Department of Medical Oncology, Keiyukai Sapporo Hospital, Sapporo, 003-0027, Japan
| | - Yozo Suzuki
- Department of Surgery, Toyonaka Municipal Hospital, Toyonaka, 560-8565, Japan
| | - Toshihiko Matsumoto
- Cancer Treatment Center, Kansai Medical University Hospital, Hirakata, 573-1191, Japan
| | - Tetsuji Terazawa
- Cancer Chemotherapy Center, Osaka Medical & Pharmaceutical University Hospital, Takatsuki, 569-8686, Japan
| | - Eiki Yamazaki
- Cancer Chemotherapy Center, Osaka Medical & Pharmaceutical University Hospital, Takatsuki, 569-8686, Japan
| | - Hiroko Hasegawa
- Department of Gastroenterology & Hepatology, National Hospital Organization, Osaka National Hospital, Osaka, 578-8588, Japan
| | - Tatsuki Ikoma
- Cancer Treatment Center, Kansai Medical University Hospital, Hirakata, 573-1191, Japan
| | - Mamoru Uemura
- Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita, 565-0871, Japan
| | - Toshifumi Yamaguchi
- Cancer Chemotherapy Center, Osaka Medical & Pharmaceutical University Hospital, Takatsuki, 569-8686, Japan
| | - Atsushi Naito
- Department of Surgery, Osaka Police Hospital, Osaka, 543-8502, Japan
| | - Yasunobu Ishizuka
- Department of Medical Oncology, Osaka International Cancer Institute, Osaka, 541-8567, Japan
| | - Yukinori Kurokawa
- Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita, 565-0871, Japan
| | - Daisuke Sakai
- Center for Cancer Genomics & Personalized Medicine, Osaka University Hospital, Suita, 565-0871, Japan
| | - Hisato Kawakami
- Department of Medical Oncology, Faculty of Medicine, Kindai University, Osaka-Sayama, 589-8511, Japan
| | - Toshio Shimokawa
- Clinical Study Support Center, Wakayama Medical University Hospital, Wakayama, 641-8509, Japan
| | | | - Takeshi Kato
- Department of Colorectal Surgery, National Hospital Organization, Osaka National Hospital, Osaka, 578-8588, Japan
| | - Taroh Satoh
- Palliative & Supportive Care Center, Osaka University Hospital, Suita, 565-0871, Japan
| | - Yoshinori Kagawa
- Department of Colorectal Surgery, Osaka General Medical Center, Osaka, 558-8588, Japan
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Zhang W, Zhang X, Zhao D, Hu M, Ge X, Xia L. An Individualized EMT-Related Gene Signature to Predict Recurrence-Free Survival in Stage II/III Colorectal Cancer Patients. Dig Dis Sci 2022; 67:5116-5126. [PMID: 35094253 DOI: 10.1007/s10620-021-07338-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 11/15/2021] [Indexed: 01/05/2023]
Abstract
BACKGROUND Approximately 30% of stage II and 50-60% of stage III colorectal cancer (CRC) patients who have undergone surgery will develop recurrence within 5 years. Thus, more reliable prognostic biomarkers are urgently needed to identify the high-risk subset of patients who will benefit from postoperative adjuvant therapy. METHODS We retrospectively analyzed 911 stage II/III CRC patients in multiple cohorts. Using a series of bioinformatic and statistical approaches, an individualized prognostic signature was established in the training cohort and validated in four other independent cohorts. An integrated decision tree was generated to improve risk stratification, and a nomogram was built to quantify risk assessment for individual patients. RESULTS Epithelial-mesenchymal transition (EMT) was identified as a dominant risk factor for recurrence-free survival (RFS) in stage II/III CRC patients. The EMT-related gene signature could discriminate high-risk subsets in a training cohort and four independent validation cohorts (with 473, 89, 130, 74 and 145 patients, respectively). Survival analyses demonstrated that the EMT-related gene signature served as an independent risk factor for RFS in different subgroups. The decision tree could optimize the risk stratification, and the nomogram could predict the 5-year RFS probability accurately. CONCLUSION The proposed EMT-related prognostic signature is a useful biomarker to predict RFS and identify the high-risk subset in stage II/III CRC patients.
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Affiliation(s)
- Wei Zhang
- Division of Gastrointestinal Surgery, The Affiliated Huai'an Hospital of Xuzhou Medical University, Huai'an, China
| | - Xiaoyu Zhang
- Division of Gastrointestinal Surgery, The Affiliated Huai'an Hospital of Xuzhou Medical University, Huai'an, China
| | - Di Zhao
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Mengwen Hu
- Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Xiaoqin Ge
- Department of Endocrinology, The Second Affiliated Hospital of Nantong University and First People's Hospital of Nantong City, Jiangsu, China
| | - Li Xia
- Department of Surgery, The Fourth People's Hospital of Huai'an, Huai'an, China.
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Systematic review of randomised clinical trials and observational studies for patients with RAS wild-type or BRAF V600E-mutant metastatic and/or unresectable colorectal cancer. Crit Rev Oncol Hematol 2022; 173:103646. [PMID: 35344913 DOI: 10.1016/j.critrevonc.2022.103646] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 02/24/2022] [Accepted: 02/28/2022] [Indexed: 02/07/2023] Open
Abstract
Approximately 8-10% of metastatic colorectal cancer (mCRC) tumours harbour BRAFV600E mutations. Eleven randomised controlled trials (RCTs) and 24 non-RCTs were identified. Seven studies evaluated BRAF inhibitors. Single-agent BRAF inhibitors had minimal efficacy, whereas BRAF inhibitor plus anti-EGFR therapy improved outcomes. In BEACON CRC, overall survival (OS) was significantly longer for patients receiving encorafenib plus cetuximab ± binimetinib when compared with irinotecan/FOLFIRI plus cetuximab as second- and third-line therapy. Seven prospective non-RCTs reported worse OS and progression-free survival (PFS) for patients with BRAFV600E-mutant vs BRAF wild-type mCRC. Eight RCTs reported that PFS and OS were generally shorter for patients with BRAFV600E-mutant mCRC vs those with KRAS or RAS wild-type mCRC. Patients with BRAFV600E-mutant mCRC have worse outcomes with conventional therapy vs patients with BRAF wild-type tumours. BRAF inhibitors in conjunction with anti-EGFR therapy improves outcomes for patients with BRAFV600E-mutant mCRC vs conventional therapy or a BRAF inhibitor alone.
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8
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Pan M, Zhao Y, He J, Wu H, Pan Y, Yu Q, Zhou S. Prognostic Value of the Glasgow Prognostic Score on Overall Survival in patients with Advanced Non-Small Cell Lung Cancer. J Cancer 2021; 12:2395-2402. [PMID: 33758615 PMCID: PMC7974889 DOI: 10.7150/jca.52215] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 01/17/2021] [Indexed: 12/26/2022] Open
Abstract
Background: Findings from previous studies regarding the association between the Glasgow Prognostic Score (GPS) and overall survival (OS) of patients with advanced non-small cell lung cancer (NSCLC) were limited. This study aimed to investigate the prognostic value of GPS in patients with advanced NSCLC after adjusting for potential confounding factors. Methods: A retrospective cohort study was conducted in 494 patients with advanced NSCLC between 2009 and 2019. Clinicopathological characteristics (including GPS) were analyzed to determine predictors of OS using univariate and multivariate Cox proportional hazards models. Survival curves were estimated using the Kaplan-Meier method. Results: Of the enrolled patients with advanced NSCLC, 66.46% were men and 53.85% were aged <60 years. The percentages of GPS scores of 0, 1, and 2 were 36.44%, 36.03%, and 27.53%, respectively. The median OS of the GPS 0, 1, and 2 groups were 23.27, 14.37, and 10.27 months, respectively (log-rank P <0.0001). A higher GPS was independently associated with an increased risk of death (P for trend = 0.0004) after full adjustment for potential confounders. The risk of death increased by 77% in the GPS 1 group (hazard ratio [HR]=1.77, 95% confidence interval [CI]=1.22-2.57, P=0.0027) and 109% in the GPS 2 group (HR=2.09, 95%CI=1.36-3.22, P=0.0008) compared with the GPS 0 group after adjustment. We did not find significant heterogeneity among the analyzed subgroups apart from sex (P interaction=0.017). Conclusion: High pretreatment GPS is independently associated with worse OS in patients with advanced NSCLC. GPS should be considered in patient counseling and decision-making and needs to be further validated by large-cohort and prospective studies.
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Affiliation(s)
- Mingmei Pan
- College of Oncology, Guangxi Medical University, No.22 Shuangyong Road, 530021, Nanning City, Guangxi Zhuang Autonomous Region, China
| | - Yun Zhao
- Department of Respiratory Oncology, Guangxi Medical University Affiliated Tumor Hospital, No.71 Heti Road, 530021, Nanning City, Guangxi Zhuang Autonomous Region, China
| | - Jianbo He
- Department of Respiratory Oncology, Guangxi Medical University Affiliated Tumor Hospital, No.71 Heti Road, 530021, Nanning City, Guangxi Zhuang Autonomous Region, China
| | - Huanqiong Wu
- College of Oncology, Guangxi Medical University, No.22 Shuangyong Road, 530021, Nanning City, Guangxi Zhuang Autonomous Region, China
| | - Yujia Pan
- College of Oncology, Guangxi Medical University, No.22 Shuangyong Road, 530021, Nanning City, Guangxi Zhuang Autonomous Region, China
| | - Qitao Yu
- Department of Respiratory Oncology, Guangxi Medical University Affiliated Tumor Hospital, No.71 Heti Road, 530021, Nanning City, Guangxi Zhuang Autonomous Region, China
| | - Shaozhang Zhou
- Department of Respiratory Oncology, Guangxi Medical University Affiliated Tumor Hospital, No.71 Heti Road, 530021, Nanning City, Guangxi Zhuang Autonomous Region, China
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GLI3 Promotes Invasion and Predicts Poor Prognosis in Colorectal Cancer. BIOMED RESEARCH INTERNATIONAL 2021; 2021:8889986. [PMID: 33506047 PMCID: PMC7814942 DOI: 10.1155/2021/8889986] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 12/02/2020] [Accepted: 12/21/2020] [Indexed: 12/13/2022]
Abstract
Purpose The epithelial–mesenchymal transition (EMT) is a key hallmark of cancer which promotes malignant progression, especially during the process of cancer invasion. A better understanding of EMT will help elucidate the molecular mechanism underlying colorectal cancer (CRC) metastasis and may provide new insights into the identification of potential biomarkers and therapeutic targets. Methods A series of bioinformatic approaches were combined and identify GLI3 as a potential key regulator in EMT. In vitro experiments were performed to knockdown GLI3 expression in two CRC cell lines and to reveal the oncogenic role of GLI3 in CRC. qRT-PCR and western blot were performed to show the influence of GLI3 in EMT and downstream pathways. The Kaplan-Meier analysis and log-rank test were used to evaluate the prognostic value of GLI3 in CRC patients. Results GLI3 was identified as a key regulator in coexpression and protein-protein interaction (PPI) networks involved in EMT. Bioinformatic analyses indicated that GLI3 had a high correlation with EMT markers in CRC. In vitro experiments showed that GLI3 knockdown attenuated the migratory and invasive capacities of CRC cells via influencing EMT property, especially by regulating phosphorylation of ERK signaling pathway. In addition, higher expression of GLI3 predicts worse prognosis in CRC patients. Conclusions In summary, we presented the first evidence that GLI3 could promote the migratory and invasive capacities of CRC cells by regulating the EMT process. Our study might provide some useful clues to a better understanding of GLI3 in EMT during CRC progression.
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Travers A, Jalali A, Begbie S, Semira C, Kosmider S, Ananda S, Wong R, Lee M, Shapiro J, Burge M, Yip D, Torres J, Ma B, Nott L, Dean A, Tie J, Khattak A, Lim S, Wong HL, Gibbs P. Real-World Treatment and Outcomes of Metastatic Colorectal Cancer Patients With a Poor or Very Poor Performance Status. Clin Colorectal Cancer 2020; 20:e21-e34. [PMID: 32919889 DOI: 10.1016/j.clcc.2020.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 08/05/2020] [Accepted: 08/09/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND The management of metastatic colorectal cancer patients with a poor performance status (PS) continues to be a clinical dilemma, with the potential activity and safety of treating this population remaining poorly understood. Few of these patients are enrolled onto clinical trials, and poor PS is often multifactorial. PATIENTS AND METHODS We analyzed the Treatment of Recurrent and Advanced Colorectal Cancer registry to describe treatment practices and outcomes in poor (Eastern Cooperative Oncology Group [ECOG] PS 2) and very poor PS (ECOG PS > 2) patients to explore the relationship between age, tumor burden, comorbidities, and PS, and to evaluate the benefit of systemic therapy. Standard descriptive statistical methods, Kaplan-Meier analysis, and a multivariate Cox regression model were used. RESULTS Of 2769 registry patients (diagnosed January 2009 to June 2018), 329 (12%) and 182 (7%) patients had a poor and very poor PS, respectively. Good PS patients were more likely to receive systemic therapy than poor and very poor PS patients (85%, 55%, and 21.5%, P < .0001), but clinician assessed response was observed in all subsets (53%, 41%, and 29%, P = .0003). Treatment with chemotherapy was associated with longer median overall survival across PS groups. Exploratory analysis based on comorbidity score and tumor burden subgroups demonstrated a consistently positive overall survival association with treatment. Benefit was observed where poor overall survival was attributable to medical comorbidities and to tumor burden. CONCLUSION In routine clinical care, a substantial proportion of poor and very poor PS patients receive active treatment, which is often associated with meaningful clinical benefit.
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Affiliation(s)
- Avraham Travers
- Department of Medical Oncology, Calvary Mater Newcastle, Waratah, Australia.
| | - Azim Jalali
- Walter and Eliza Hall Institute of Medical Research, Parkville, Australia; Western Health, Footscray, Australia
| | - Stephen Begbie
- Mid North Coast Cancer Institute, Port Macquarie, Australia
| | - Christine Semira
- Walter and Eliza Hall Institute of Medical Research, Parkville, Australia
| | | | - Sumitra Ananda
- Walter and Eliza Hall Institute of Medical Research, Parkville, Australia; Western Health, Footscray, Australia; Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia; Dentistry and Health Sciences, Faculty of Medicine, University of Melbourne, Parkville, Australia
| | - Rachel Wong
- Walter and Eliza Hall Institute of Medical Research, Parkville, Australia; Eastern Health, Box Hill, Australia; Eastern Health Clinical School, Monash University, Box Hill, Australia; Epworth Healthcare, Box Hill, Australia
| | - Margaret Lee
- Walter and Eliza Hall Institute of Medical Research, Parkville, Australia; Western Health, Footscray, Australia; Eastern Health, Box Hill, Australia; Eastern Health Clinical School, Monash University, Box Hill, Australia
| | - Jeremy Shapiro
- Haematology and Medical Oncology Unit, Cabrini Hospital, Malvern, Australia; Department of Medicine, Monash University, Clayton, Australia
| | - Matthew Burge
- Royal Brisbane and Women's Hospital, Herston, Australia; University of Queensland, St Lucia, Australia
| | - Desmond Yip
- Department of Medical Oncology, Canberra Hospital, Garran, Australia; ANU Medical School, Australian National University, Canberra, Australia
| | - Javier Torres
- Goulburn Valley Health, Shepparton, Australia; Dentistry and Health Sciences-Shepparton Campus, Faculty of Medicine, University of Melbourne, Shepparton, Australia
| | - Brigette Ma
- Chinese University of Hong Kong Prince of Wales Hospital, Department of Clinical Oncology, State Key Laboratory of Translational Oncology, Shatin, New Territories, Hong Kong SAR, China
| | | | - Andrew Dean
- Bendat Cancer Centre, St John of God Subiaco Hospital, Subiaco, Australia
| | - Jeanne Tie
- Walter and Eliza Hall Institute of Medical Research, Parkville, Australia; Western Health, Footscray, Australia; Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia; Dentistry and Health Sciences, Faculty of Medicine, University of Melbourne, Parkville, Australia
| | | | - Stephanie Lim
- Macarthur Cancer Therapy Centre, Campbelltown Hospital, Campbelltown, Australia
| | - Hui-Li Wong
- Walter and Eliza Hall Institute of Medical Research, Parkville, Australia; Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Peter Gibbs
- Walter and Eliza Hall Institute of Medical Research, Parkville, Australia; Western Health, Footscray, Australia
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Taberna DJ, Navas-Carretero S, Martinez JA. Current nutritional status assessment tools for metabolic care and clinical nutrition. Curr Opin Clin Nutr Metab Care 2019; 22:323-328. [PMID: 31246586 DOI: 10.1097/mco.0000000000000581] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE OF REVIEW The aim of this report is to critically review existing questionnaires and tools to assess nutritional status in different populations and pathological conditions. RECENT FINDINGS A total of 16 instruments to evaluate nutritional status were recorded, which were based on anthropometrical determinations, biochemical markers, clinical examinations and subjective questionnaires, depending on the nutritional assessment focus, involving different concepts: screening of the risk, diagnosis and severity of malnutrition, as well as the consequences of undernutrition or overnutrition. SUMMARY A variety of questionnaires, equations and tools were found with ability to assess nutritional status for metabolic care or clinical nutrition purposes, but apparently there is no optimal, universal and reliable nutritional status screening system for all metabolic conditions. Novel assessment instruments should provide high sensibility and specificity, be precise and reliable as well as inexpensive and simple, in order to avoid the additional burden of excessive loads of costs, work and time while dynamically overcoming the influence of disease diversity.
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Affiliation(s)
- Daniel J Taberna
- Centre for Nutrition Research, Department of Nutrition, Food Science and Physiology, University of Navarra, C/Irunlarrea, Pamplona
| | - Santiago Navas-Carretero
- Centre for Nutrition Research, Department of Nutrition, Food Science and Physiology, University of Navarra, C/Irunlarrea, Pamplona
- CIBERobn, Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Pabellón 11. Planta, Madrid
- Navarra Health Research Institute (IDISNA), Recinto de Complejo Hospitalario de Navarra (Edificio LUNA-Navarrabiomed) C/Irunlarrea, Pamplona
| | - Jose A Martinez
- Centre for Nutrition Research, Department of Nutrition, Food Science and Physiology, University of Navarra, C/Irunlarrea, Pamplona
- CIBERobn, Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Pabellón 11. Planta, Madrid
- Navarra Health Research Institute (IDISNA), Recinto de Complejo Hospitalario de Navarra (Edificio LUNA-Navarrabiomed) C/Irunlarrea, Pamplona
- Program for Precision Nutrition, IMDEA, Carr. de Cantoblanco, Madrid, Spain
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