An inflammation based score can optimize the selection of patients with advanced cancer considered for early phase clinical trials
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.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2014 |
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| Erschienen: |
2014 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:9 |
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| Enthalten in: |
PloS one - 9(2014), 1 vom: 01., Seite e83279 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Pinato, David J [VerfasserIn] |
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| Links: |
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| Themen: |
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| Anmerkungen: |
Date Completed 16.09.2014 Date Revised 10.04.2022 published: Electronic-eCollection Citation Status MEDLINE |
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| doi: |
10.1371/journal.pone.0083279 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM234338180 |
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| 100 | 1 | |a Pinato, David J |e verfasserin |4 aut | |
| 245 | 1 | 3 | |a An inflammation based score can optimize the selection of patients with advanced cancer considered for early phase clinical trials |
| 264 | 1 | |c 2014 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
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| 500 | |a Date Completed 16.09.2014 | ||
| 500 | |a Date Revised 10.04.2022 | ||
| 500 | |a published: Electronic-eCollection | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a 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) | ||
| 520 | |a 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) | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 700 | 1 | |a Stavraka, Chara |e verfasserin |4 aut | |
| 700 | 1 | |a Flynn, Michael J |e verfasserin |4 aut | |
| 700 | 1 | |a Forster, Martin D |e verfasserin |4 aut | |
| 700 | 1 | |a O'Cathail, Séan M |e verfasserin |4 aut | |
| 700 | 1 | |a Seckl, Michael J |e verfasserin |4 aut | |
| 700 | 1 | |a Kristeleit, Rebecca S |e verfasserin |4 aut | |
| 700 | 1 | |a Olmos, David |e verfasserin |4 aut | |
| 700 | 1 | |a Turnbull, Samantha J |e verfasserin |4 aut | |
| 700 | 1 | |a Blagden, Sarah P |e verfasserin |4 aut | |
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