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An inflammation based score can optimize the selection of patients with advanced cancer considered for early phase clinical trials.

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  • معلومة اضافية
    • المصدر:
      Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE
    • بيانات النشر:
      Original Publication: San Francisco, CA : Public Library of Science
    • الموضوع:
      Patient Selection*; Clinical Trials as Topic/*standards ; Inflammation/*pathology ; Neoplasms/*pathology; Aged ; Aged, 80 and over ; Blood Platelets/pathology ; Female ; Humans ; Inflammation/diagnosis ; Leukocyte Count ; Lymphocytes/pathology ; Male ; Middle Aged ; Neoplasm Metastasis ; Neoplasm Staging ; Neoplasms/mortality ; Neoplasms/therapy ; Neutrophils/pathology ; Platelet Count ; Prognosis ; Reproducibility of Results ; Retrospective Studies ; Treatment Outcome ; Tumor Burden
    • نبذة مختصرة :
      Background: Adequate organ function and good performance status (PS) are common eligibility criteria for phase I trials. As inflammation is pathogenic and prognostic in cancer we investigated the prognostic performance of inflammation-based indices including the neutrophil (NLR) and platelet to lymphocyte ratio (PLR).
      Methods: We studied inflammatory scores in 118 unselected referrals. NLR normalization was recalculated at disease reassessment. Each variable was assessed for progression-free (PFS) and overall survival (OS) on uni- and multivariate analyses and tested for 90 days survival (90DS) prediction using receiving operator curves (ROC).
      Results: We included 118 patients with median OS 4.4 months, 23% PS>1. LDH≥450 and NLR≥5 were multivariate predictors of OS (p<0.001). NLR normalization predicted for longer OS (p<0.001) and PFS (p<0.05). PS and NLR ranked as most accurate predictors of both 90DS with area under ROC values of 0.66 and 0.64, and OS with c-score of 0.69 and 0.60. The combination of NLR+PS increased prognostic accuracy to 0.72. The NLR was externally validated in a cohort of 126 subjects.
      Conclusions: We identified the NLR as a validated and objective index to improve patient selection for experimental therapies, with its normalization following treatment predicting for a survival benefit of 7 months. Prospective validation of the NLR is warranted.
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    • Grant Information:
      United Kingdom Wellcome Trust; United Kingdom Cancer Research UK
    • الموضوع:
      Date Created: 20140111 Date Completed: 20140916 Latest Revision: 20220410
    • الموضوع:
      20240829
    • الرقم المعرف:
      PMC3883636
    • الرقم المعرف:
      10.1371/journal.pone.0083279
    • الرقم المعرف:
      24409281