Document Detail


Systemic inflammatory status at baseline predicts bevacizumab benefit in advanced non-small cell lung cancer patients.
MedLine Citation:
PMID:  23760488     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Bevacizumab is a humanized anti-VEGF monoclonal antibody able to produce clinical benefit in advanced non-squamous non-small-cell lung cancer (NSCLC) patients when combined to chemotherapy. At present, while there is a rising attention to bevacizumab-related adverse events and costs, no clinical or biological markers have been identified and validated for baseline patient selection. Preclinical findings suggest an important role for myeloid-derived inflammatory cells, such as neutrophils and monocytes, in the development of VEGF-independent angiogenesis. We conducted a retrospective analysis to investigate the role of peripheral blood cells count and of an inflammatory index, the neutrophil-to-lymphocyte ratio (NLR), as predictors of clinical outcome in NSCLC patients treated with bevacizumab plus chemotherapy. One hundred and twelve NSCLC patients treated with chemotherapy ± bevacizumab were retrospectively evaluated for the predictive value of clinical or laboratory parameters correlated with inflammatory status. Univariate analysis revealed that a high number of circulating neutrophils and monocytes as well as a high NLR were associated with shorter progression-free survival (PFS) and overall survival (OS) in bevacizumab-treated patients only. We have thus developed a model based on the absence or the presence of at least one of the above-mentioned inflammatory parameters. We found that the absence of all variables strongly correlated with longer PFS and OS (9.0 vs. 7.0 mo, HR: 0.39, p = 0.002; and 20.0 vs. 12.0 mo, HR: 0.29, p < 0.001 respectively) only in NSCLC patients treated with bevacizumab plus chemotherapy. Our results suggest that a baseline systemic inflammatory status is marker of resistance to bevacizumab treatment in NSCLC patients.
Authors:
Cirino Botta; Vito Barbieri; Domenico Ciliberto; Antonio Rossi; Danilo Rocco; Raffaele Addeo; Nicoletta Staropoli; Pierpaolo Pastina; Giulia Marvaso; Ignazio Martellucci; Annamaria Guglielmo; Luigi Pirtoli; Pasquale Sperlongano; Cesare Gridelli; Michele Caraglia; Pierfrancesco Tassone; Pierosandro Tagliaferri; Pierpaolo Correale
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Cancer biology & therapy     Volume:  14     ISSN:  1555-8576     ISO Abbreviation:  Cancer Biol. Ther.     Publication Date:  2013 Jun 
Date Detail:
Created Date:  2013-06-13     Completed Date:  2014-01-14     Revised Date:  2014-06-03    
Medline Journal Info:
Nlm Unique ID:  101137842     Medline TA:  Cancer Biol Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  469-75     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Antibodies, Monoclonal, Humanized / administration & dosage
Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
Carcinoma, Non-Small-Cell Lung / drug therapy*,  immunology,  mortality,  pathology
Disease-Free Survival
Female
Humans
Lung Neoplasms / drug therapy*,  immunology,  mortality,  pathology
Lymphocyte Count
Male
Middle Aged
Multivariate Analysis
Neoplasm Staging
Neutrophils / immunology
Platelet Count
Platinum Compounds / administration & dosage
Retrospective Studies
Treatment Outcome
Chemical
Reg. No./Substance:
0/Antibodies, Monoclonal, Humanized; 0/Platinum Compounds; 2S9ZZM9Q9V/bevacizumab
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