Role of Predictive Value of the Modified Glasgow Prognostic Score for Later-line Chemotherapy in Patients With Metastatic Colorectal Cancer

707 Background: Although inextricably linked, both comorbidity and systemic inflammatory responses have been shown to determine survival in patients undergoing surgery for colorectal cancer (CRC). The present study examines the interrelationships between comorbidity (ASA grade) and systemic inflammation (modified Glasgow Prognostic Score (mGPS)) in patients from the ScotScan dataset. Methods: Clinicopathological characteristics and outcome of consecutive patients undergoing potentially curative resection of TNM I-III CRC in Glasgow Royal Infirmary (Scotland) and Sørlandet Hospital (Norway) were prospectively collected. ASA grade and mGPS (0-CRP ≤ 10mg/L, 1-CRP > 10mg/L, 2-CRP > 10mg/L and albumin < 35g/L) prior to surgery was recorded and relationship with overall survival (OS) examined. Results: 2,295 patients (Scotland: n = 1,234 , Norway: n = 1,061) were included. Patients from Norway were more likely to be older, female and have higher ASA grade (all P < 0.001), and more likely to have colon cancer (76% vs. 67%, P < 0.001). Patients from Norway were less likely to be systemically inflamed (mGPS = 0: 72% vs. 65%, P < 0.001), even after propensity score matching ( n = 736, OR 0.36 95%CI0.25-0.51, P < 0.001). ASA grade and mGPS were significantly associated; 21% of ASA 1 patients had mGPS ≥ 1 compared to 41% of ASA four patients ( P < 0.001). In the propensity-matched cohort, both increasing ASA (HR 1.98 95% CI1.57-2.49, P < 0.001) and mGPS (HR 1.20 95% CI1.02-1.41, P = 0.027) were associated with OS independent of age, N stage and adjuvant therapy use; results in the whole cohort were similar. The combination of ASA grade and mGPS was examined with respect to OS in patients with stage II-III CRC (Table 1). In patients with stage II disease, 3-year OS was stratified from 96% (ASA 1, mGPS0) to 67% (ASA 3, mGPS2) ( P < 0.001); in patients with stage II disease, 3-year OS was stratified from 84% to 44% ( P < 0.001). Conclusions: Using a large, prospectively collected dataset of patients undergoing resection of CRC in two countries, the results of the present study confirm the independent prognostic value of measures of comorbidity and systemic inflammation prior to surgery.

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The impact of the Glasgow Prognostic Score on survival in second-line chemotherapy for metastatic colorectal cancer patients with BRAF V600E mutation

Therapeutic Advances in Medical Oncology ◽

10.1177/1758835918820298 ◽

2019 ◽

Vol 11 ◽

pp. 175883591882029 ◽

Cited By ~ 2

Author(s):

Seiichiro Mitani ◽

Hiroya Taniguchi ◽

Keiji Sugiyama ◽

Toshiki Masuishi ◽

Kazunori Honda ◽

...

Keyword(s):

Colorectal Cancer ◽

Metastatic Colorectal Cancer ◽

Cancer Patients ◽

Prognostic Score ◽

Braf V600e Mutation ◽

Braf V600e ◽

Second Line ◽

Second Line Chemotherapy ◽

Colorectal Cancer Patients ◽

Line Chemotherapy

Background: BRAF (v-raf murine sarcoma viral oncogene homolog B1) V600E mutant colorectal cancer is associated with short survival. Recently, clinical trials have been conducted to improve outcomes of second or later lines of chemotherapy. However, there is a paucity of reference data pertaining to outcomes of second-line chemotherapy and prognostic factors that are relevant only to BRAF mutant patients. Patients and methods: We retrospectively reviewed metastatic colorectal cancer patients with BRAF V600E mutation who underwent second-line chemotherapy between January 2007 and March 2017. We evaluated treatment outcomes and performed prognostic analyses. Results: A total of 52 patients were included. The median progression-free survival and overall survival (OS) were 2.5 [95% confidence interval (CI) = 1.91–4.11] and 6.5 (95% CI = 4.30–9.63) months, respectively. Overall response and disease control rates were 7% and 48%, respectively. All the regimens which elicited a partial response included BRAF inhibitors in combination with anti-epidermal growth factor receptor (EGFR) antibodies. Therefore, the overall response was 0% after exclusion of patients treated with study drugs. Multivariate analysis for OS revealed that the Glasgow Prognostic Score (GPS), elevated lactate dehydrogenase, and poor performance status were independent prognostic factors. In particular, survival curves according to the GPS stratified the patients into distinct risk groups. The median OSs in patients with GPS of 0, 1, and 2 were 9.9, 5.0, and 1.9 months, respectively. Conclusions: Outcomes of second-line chemotherapy for metastatic colorectal cancer patients with BRAF V600E mutation were extremely poor. GPS may be useful in future clinical trials.

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Utility of the modified Glasgow prognostic score in patients with metastatic renal cell carcinoma treated with targeted agents.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.5_suppl.441 ◽

2012 ◽

Vol 30 (5_suppl) ◽

pp. 441-441

Author(s):

Mikhail Y. Akbashev ◽

Brian Michael Lingerfelt ◽

Yuan Liu ◽

Omer Kucuk ◽

Viraj A. Master ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Predictive Value ◽

Renal Cell ◽

Prognostic Score ◽

Glasgow Prognostic Score ◽

Targeted Agents ◽

Inclusion Criteria ◽

Modified Glasgow Prognostic Score ◽

Pre Treatment

441 Background: The modified Glasgow prognostic score (mGPS) is a pre-treatment prognostic system based on inflammatory biomarkers that is comparable in accuracy to the Memorial Sloan-Kettering Cancer Center (MSKCC) score for patients with metastatic renal cell carcinoma (mRCC) treated with cytokines. However, data are limited regarding the current utility of prognostic models developed in the cytokine era. In this study we examined the correlation between pre-treatment and post-treatment mGPS values and clinical benefit response (CBR) in patients treated with targeted agents for mRCC. Methods: After obtaining approval from the Emory Institutional Review Board, mGPS values were determined retrospectively using published methods and measurements of serum C-reactive protein (CRP) and serum albumin from patients who received targeted therapy for mRCC of any histology at the Emory Winship Cancer Institute between January 1, 2005 and June 30, 2011. CBR was defined as complete response (CR), partial response (PR) and stable disease (SD). Inclusion criteria included availability of at least 3 CRP values per patient. Results: Of the 635 patients who were screened, 56 were found to meet inclusion criteria. Of these, 43 received one evaluable line(s) of therapy (ELOT), 9 received two, 3 received three and 1 received four. The 74 ELOT included temsirolimus (16), sunitinib (20), sorafenib (14), pazopanib (20), everolimus (3) and bevacizumab/interferon (1). The correlation of post-treatment mGPS values to CBR was greater than pre-treatment mGPS values with sensitivity (81%), specificity (87%), positive predictive value (85%) and negative predictive value (83%). The p values were <0.001 for each parameter. Conclusions: Although these data require prospective validation, they provide evidence for the prognostic utility of mGPS assessments before and after therapy with targeted agents. Of note, the likelihood of having a CBR was much greater in patients who achieved or maintained an mGPS value of 0 after therapy. If confirmed, serial assessments of the mGPS to determine inflammatory response rates may prove to be a valuable and cost effective tool for patient care and drug development in mRCC.

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