Predictive factors for early mortality after initiation of regorafenib or trifluridine/tipiracil in refractory metastatic colorectal cancer.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 3560-3560
Author(s):  
Toshiki Masuishi ◽  
Toshikazu Moriwaki ◽  
Shota Fukuoka ◽  
Atsuo Takashima ◽  
Yosuke Kumekawa ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Multivariate Analysis ◽  
Mortality Rate ◽  
Metastatic Colorectal Cancer ◽  
Predictive Factors ◽  
Univariate Analysis ◽  
Tumor Resection ◽  
Early Mortality ◽  
Cox Proportional Hazards Model ◽  
P Value

3560 Background: Regorafenib (REG) and trifluridine/tipiracil (FTD/TPI) have been recognized as standard treatments for patients (pts) with refractory metastatic colorectal cancer (mCRC). Because these drugs have limits on efficacy benefit for some pts, we are necessary to select pts who may be better not to receive REG or FTD/TPI. However, no reports are available on how to predict pts with early mortality after initiation of these drugs. Methods: We retrospectively evaluated pts with mCRC who were registered in a multicenter observational study (the REGOTAS study). The main inclusion criteria were ECOG PS of 0–2, refractory or intolerant to fluoropyrimidines, oxaliplatin, irinotecan, and anti-VEGF and anti-EGFR therapy (if KRAS wild type), and no prior use of REG or FTD/TPI. Predictive factors for early mortality (≤ 12 weeks from initiation of REG or FTD/TPI) were evaluated by multivariate analysis for survival with all variables with P values of <0.05 from the univariate analysis, using the Cox proportional hazards model. In this analysis, the pts who lived at first 15 weeks were defined as censored case. Results: A total of 523 pts (REG, 212; FTD/TPI, 311) were eligible. Predictive factors for early mortality were without primary tumor resection [adjusted hazard ratio (aHR), 1.56; p = 0.02], the low level of albumin (aHR, 2.31; p < 0.0001), the high level of CRP (aHR, 2.31; p < 0.0001), and short time from diagnosis of mCRC (aHR, 1.77; p = 0.002) by multivariate analysis. The pts harboring all these poor factors were classified into the high (H) risk of early mortality group. Two groups of pts with H and non-H were identified, with 12-week mortality rate of 39 and 14%, with 14-week mortality rate of 70 and 18%, and with median survival time (MST) of 2.9 and 7.8 months, respectively (HR of H/non-H, 4.02; p value < 0.0001). In pts treated with REG, H and non-H groups had 12-week mortality rate of 38 and 16%, 14-week mortality rate of 79 and 18%, and MST of 2.8 and 7.8 months, respectively. In pts treated with FTD/TPI, H and non-H groups had 12-week mortality rate of 41 and 13%, 14-week mortality rate of 63 and 18%, and MST of 3.2 and 7.7 months, respectively. Conclusions: Our predictive model for early mortality after initiation of REG or FTD/TPI might be useful for selecting pts who should not receive either these drugs.

Polymorphisms of pluripotency transcription factors for predicting cetuximab efficacy in metastatic colorectal cancer: Data from FIRE-3 and TRIBE trials.

2021 ◽  
Vol 39 (3_suppl) ◽  
pp. 98-98
Author(s):  
Hiroyuki Arai ◽  
Joshua Millstein ◽  
Fotios Loupakis ◽  
Sebastian Stintzing ◽  
Jingyuan Wang ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Multivariate Analysis ◽  
Transcription Factors ◽  
Metastatic Colorectal Cancer ◽  
Univariate Analysis ◽  
Cox Proportional Hazards Model ◽  
Predictive Values ◽  
Cancer Data ◽  
In Fire ◽  
Encoding Genes

98 Background: Cancer stem cells are subpopulation of cancer cells characterized by the self-renewal ability, and primarily maintained by a network of pluripotency transcription factors (PTFs). Despite their chemo-resistant phenotype, recent clinical trials data show cetuximab (Cet) is more beneficial for a subset of metastatic colorectal cancer (mCRC) categorized in a mesenchymal/stem-like subtype based on transcriptomic classifications. We investigated whether single nucleotide polymorphisms (SNPs) in PTF encoding genes have predictive values for the efficacy of Cet in mCRC patients. Methods: Genomic and clinical data from three independent cohorts of patient treated with first-line chemotherapy ( n = 451, in total) were tested: Cet cohort (FOLFIRI+Cet arm in FIRE-3 trial, n = 129); bevacizumab (Bev) cohort 1 (FOLFIRI+Bev arm in FIRE-3 trial, n = 107) and Bev cohort 2 (FOLFIRI+Bev arm in TRIBE trial, n = 215), as controls. Genomic DNA extracted from blood samples was genotyped using an OncoArray (Illumina, Inc., San Diego, CA, USA). Eight SNPs in PTF encoding genes ( NANOG rs11055786, NANOG rs11055767, NANOGP8 rs2168958, NANOGP8 rs9944179, POU5F1 rs3130501, POU5F1 rs3130932, SOX2 rs11915160, and MYC rs3891248) were tested for association with progression-free survival (PFS) and overall survival (OS), using Cox proportional hazards model. Results: In the Cet cohort, three SNPs were significantly associated with PFS in univariate analysis: NANOG rs11055767 (C/C vs any A allele, hazard ratio [HR] = 0.62, 95% confidence interval [CI] = 0.42–0.94, log-rank p = 0.02), NANOGP8 rs2168958 (A/A vs any C allele, HR = 2.12, 95% CI = 1.36–3.29, log-rank p < 0.01), and NANOGP8 rs9944179 (G/G vs any A allele, HR = 3.68, 95% CI = 1.46–9.31, log-rank p < 0.01). Multivariate analysis confirmed the significance in NANOGP8 rs2168958 and NANOGP8 rs9944179. Furthermore, two SNPs were significantly associated with OS in multivariate analysis: POU5F1 rs313051 (G/G vs any A allele, HR = 0.46, 95% CI = 0.22–0.99, adjusted p = 0.04) and POU5F1 rs3130932 (A/A vs any C allele, HR = 0.46, 95% CI = 0.22–0.93, adjusted p = 0.03). Both in the Bev cohorts 1 and 2, no significant associations between the SNPs and clinical outcomes were observed. Conclusions: The current findings suggest that polymorphisms in the PTF genes could be predictive markers for Cet in patients with mCRC. Further studies are warranted to validate the predictive utility.

scholarly journals COLORECTAL CANCER

2009 ◽  
Vol 16 (04) ◽  
pp. 492-498
Author(s):  
MUHAMMAD AKRAM ◽  
JAVAID IQBAL ◽  
WASIM AMER
Keyword(s):  
Colorectal Cancer ◽  
Predictive Factors ◽  
Cox Regression ◽  
Univariate Analysis ◽  
Tumor Resection ◽  
Proximal Colon ◽  
Female Ratio ◽  
Colon Tumors ◽  
Pre Treatment ◽  
Complete Tumor

There is paucity of data on epidemiology and survival in colorectal cancer from developing countries. O b j e c t i v e s : To determineoverall survival and its predictive factors. S e t t i n g : Department of Oncology Jinnah Hospital Lahore. P e r i o d : From July 1997 to Dec2007.Methods: 73 patients were analyzed. Patient demographic data including age, sex, socio-economic status, pre-treatment CEA levels,Duke's stage, site of tumor (colon, rectum) and complete tumor resectability were recorded. Univariate analysis by chi-square and multivariateanalysis were performed by Cox Regression Model to evaluate the predictors of survival. SPSS v 13.0 was used for statistical analysis. Kaplan-Meier estimate was used to calculate survival. R e s u l t s : Median age of our patients was 45 years. Male to female ratio was 1:1.2. Completesurgical resection could be performed in only 48 (68.5%) patients. Majority (70%) patients had Duke C and D. Overall survivals at 36 monthswas 53 % and was 90% for Duke A and B, while it was 61% and 26% for Duke's C and D respectively. Females had a better survival rate of74% as compared to males with a survival of 36%. Patients with proximal colon tumors had survival of 73% as compared to 37% in rectal/rectosigmoidgroup. Patients with high pre-treatment CEA had poor survival 39%. Only 25% patients with unresectable tumors were alive at 36months compared to 67% in patients with resectable tumors. Conclusion: Significant predictive factors for improved survival were female gender,early disease, patients with proximal colon tumors, low pre-treatment CEA levels and complete tumor resection.

Genes involved in EGFR-degradation to predict for efficacy in metastatic colorectal cancer patients treated with cetuximab.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 3557-3557
Author(s):  
Sebastian Stintzing ◽  
Wu Zhang ◽  
Takeru Wakatsuki ◽  
Yan Ning ◽  
Nico Benjamin Volz ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Clinical Trials ◽  
Metastatic Colorectal Cancer ◽  
Univariate Analysis ◽  
Resistance Mechanism ◽  
Progression Free Survival ◽  
P Value ◽  
Nucleotide Polymorphisms ◽  
Free Survival ◽  
Receptor Endocytosis

3557 Background: As many transmembrane receptors, the epithelial growth factor receptor (EGFR) has a highly regulated turnover leading to inactivation and recycling or degradation after activation. This process can be divided into four different phases: receptor endocytosis, ubiquitation/neddylation, recycling and degradation. We tested whether functional significant single nucleotide polymorphisms in genes involved in the degradation pathway will predict clinical outcome (response, PFS and OS) in 108 patients with metastatic colorectal cancer enrolled in clinical trials and treated with cetuximab. Methods: Genomic DNA was isolated from blood from 108 patients treated with cetuximab enrolled in one of two clinical trials. All patients were KRAS and BRAF wildtyp. 20 SNPs were selected based on the involvement in receptor endocytosis (CBL, CIN85, endophilin) ubiquitation/neddylation, recycling and degradation (CBL, EPS15, Ubc12, UbcH7). Minor allele frequency had to by higher than 10%. PCR and product sequencing were done using standard procedures. Uni- and multivariate analyses, adjusting for age, gender, rash and racial background, were carried out. Results: In univariate analysis, rs895374 (HR: 1.69; p= 0.03), which is located in the exome of UbcH7, was able to separate patient cohorts significantly in perspective of progression free survival (CC = 5.7mo, CA= 3.6mo, AA= 3.4mo). Using multivariate analysis, rs895375 stayed to be a significant predictor of progression free survival with a Hazard ratio of 2.08 (95% CI 1.24 – 3.48) and a p value of 0.005. UbcH7 plays a pivotal role in the process of neddylation (adding NEDD8 to the EGFR), which switch the balance between recycling and degradation of the EGFR towards degradation. Conclusions: The process of EGFR recycling is important mechanism of resistance of cetuximab in colorectal cancer. This is the first report suggesting that germline polymorphisms in the degradation process may predict efficacy of cetuximab in patients with metastatic colorectal cancer. Anti-EGFR antibody like Sym004 might overcome this resistance mechanism by preventing EGFR recycling.

The prognostic value of serum IL-6 and YKL-40 in patients with metastatic colorectal cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e15060-e15060
Author(s):  
Benny Vittrup Jensen ◽  
Mathias Holsey Gramkow ◽  
Camilla Stedstrup Mosgaard ◽  
Christian Dehlendorff ◽  
Per Pfeiffer ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Multivariate Analysis ◽  
Metastatic Colorectal Cancer ◽  
Prognostic Value ◽  
Cox Regression ◽  
Univariate Analysis ◽  
Continuous Variables ◽  
Female Ratio ◽  
Cox Regression Analysis ◽  
L 14

e15060 Background: The prognostic value of serum IL-6, YKL-40 and CEA before first (1) and third line therapy (3LT) in metastatic colorectal cancer (mCRC) is lacking and was evaluated in this study. Methods: From 2004 to 2015 serum samples were collected from 160 and 255 patients with mCRC before 1LT and 3LT, respectively. Median age was 64 years (range 33-87) and male/female ratio 243(59%)/172(41%). Serum IL-6 (R&D, UK) and YKL-40 (Quidel, USA) were determined by ELISA. Progression-free (PFS) and overall survival (OS), crude and adjusted hazard ratios (HR) and corresponding 95% confidence intervals (CI) were estimated with Cox regression analysis. CEA, IL-6 and YKL-40 were included as log2-transformed continuous variables with mutual adjustment between CEA, IL-6 and YKL-40, primary tumor location, sex and age. Results: In 3LT IL-6, YKL-40 and CEA levels were higher (P < 0.001) than in 1LT (IL-6: 9.5 pg/ml [IQR4.2-18.5] vs. 4.6 [2.5-10.5]; YKL-40: 140 ng/ml [77-272] vs. 101 [62-172]; and CEA: 59 ug/l [14-288] vs. 23[5.8-153]). In 3LT univariate analysis showed that increased levels of IL-6, YKL-40 and CEA were associated with shorter PFS (IL-6: HR = 1.19, 95% CI 1.07-1.31, P < 0.01; YKL-40: HR = 1.13, 1.04-1.24, P = 0.01; CEA: HR = 1.05, 1.00-1.09, P = 0.04). In 1LT only high IL-6 was associated with shorter PFS (HR = 1.09, 1.01-1.17, P = 0.03). In a multivariate analysis only high IL-6 was significantly associated with shorter PFS in 3LT (HR = 1.15, 1.03-1.29, P < 0.01) and none of the biomarkers in 1LT. In 3LT univariate analysis showed that increased levels of all 3 biomarkers were associated with a shorter OS (IL-6: HR = 1.36, 1.23-1.51, P < 0.01; YKL-40: HR = 1.21, 1.10-1.33, P < 0.01; CEA: HR = 1.11, 1.06-1.16, P < 0.01). In 1LT high levels of IL-6 (HR = 1.17, 1.08-1.27, P < 0.01) and YKL-40 (HR = 1.18, 1.00-1.38, P = 0.05), but not CEA, were associated with short OS. In 3LT the multivariate analysis showed that both higher IL-6 (HR = 1.34, 1.20-1.50, P < 0.01) and CEA (HR = 1.09, 1.03-1.14, P < 0.01), but not YKL-40 were significantly associated with a shorter OS. In 1LT only higher IL-6 was associated with a shorter OS (HR = 1.19, 1.08-1.31, P < 0.01) Conclusions: Serum IL-6 and YKL-40 may be useful prognostic biomarkers in combination with CEA in patients with mCRC

scholarly journals Skin Toxicity as Predictor of Survival in Refractory Patients with RAS Wild-Type Metastatic Colorectal Cancer Treated with Cetuximab and Avelumab (CAVE) as Rechallenge Strategy

Cancers ◽  
2021 ◽  
Vol 13 (22) ◽  
pp. 5715
Author(s):  
Davide Ciardiello ◽  
Vincenzo Famiglietti ◽  
Stefania Napolitano ◽  
Lucia Esposito ◽  
Nicola Normanno ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Multivariate Analysis ◽  
Metastatic Colorectal Cancer ◽  
Statistical Significance ◽  
Univariate Analysis ◽  
Progression Free Survival ◽  
Skin Toxicity ◽  
Circulating Tumor Dna ◽  
Wild Type ◽  
Line Of Therapy

The single-arm phase II CAVE mCRC trial evaluated the combination of cetuximab plus avelumab as rechallenge strategy in RAS wild-type (WT) metastatic colorectal cancer (mCRC) patients, with clinical response to first-line anti-EGFR-based chemotherapy, who progressed and received a subsequent line of therapy. The correlation of skin toxicity (ST) and different clinico-molecular variables with overall survival (OS), progression-free survival (PFS) and response rate (RR) was assessed at univariate and multivariate analysis. A total of 33/77 (42.9%) patients experienced grade 2–3 ST and displayed median OS (mOS) of 17.8 months (CI 95%, 14.9–20.6); whereas 44/77 (57.1%) patients with grade 0–1 ST exhibited mOS of 8.2 months (CI 95%, 5.5–10.9), (hazard ratio (HR), 0.51; CI 95%, 0.29–0.89; p = 0.019). Median PFS (mPFS) was 4.6 months (CI 95%, 3.4–5.7) in patients with grade 2–3 ST, compared to patients with grade 0–1 ST with mPFS of 3.4 months (CI 95%, 2.7–4.1; HR, 0.49; CI 95%, 0.3–0.8; p = 0.004). Grade 2–3 ST (HR, 0.51; CI 95%, 0.29–0.89; p = 0.019) and RAS/BRAF/EGFR WT circulating tumor DNA (ctDNA) (HR, 0.50; CI 95%, 0.27–0.9; p = 0.019) had a statistically significant effect on OS at univariate analysis. At the multivariate analysis, RAS/BRAF/EGFR WT ctDNA status maintained statistical significance (HR, 0.49; CI 95%, 0.27–0.9; p = 0.023), whereas there was a trend towards ST grade 2–3 (HR, 0.54; CI 95%, 0.29–1.01; p = 0.054). Skin toxicity is a promising biomarker to identify patients with mCRC that could benefit of anti-EGFR rechallenge.

HIF-1 alpha expression as a predictor of bevacizumab efficacy in metastatic colorectal cancer.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 601-601 ◽  
Author(s):  
Giorgia Marisi ◽  
Paola Ulivi ◽  
Emanuela Scarpi ◽  
Alessandro Passardi ◽  
Giovanni Luca Frassineti ◽  
...  
Keyword(s):  
Gene Expression ◽  
Colorectal Cancer ◽  
Metastatic Colorectal Cancer ◽  
Cox Model ◽  
Univariate Analysis ◽  
Objective Response ◽  
Predictive Biomarkers ◽  
Cox Proportional Hazards Model ◽  
Control Group ◽  
Expression Levels

601 Background: Assome controversies exist regarding the efficacy of bevacizumab (B) for the treatment of metastatic colorectal cancer (mCRC), novel predictive biomarkers are needed to improve patient selection and optimize the use of this agent. We analyzed the potential usefulness of five circulating biomarkers as predictors of B efficacy and in monitoring the disease. Methods: Peripheral blood samples collected at different times (baseline, first clinical evaluation and disease progression) were available for 62 of the 376 patients enrolled in the prospective multicentric ITACa trial (NCT01878422) and randomized to receive FOLFOX4/FOLFIRI (CT) with or without B. Thirty-one of the 62 patients received CT plus B and31 received CT only (control group). All patients were evaluated for response according to RECIST criteria. mRNA was isolated and used for gene expression analysis of HIF-1α, COX2, VEGF-A, EPHB4 and eNOS by a quantitative RT-PCR method. Baseline expression levels of the markers and their modulation during therapy were correlated with objective response (OR) (median test), progression-free (PFS) and overall survival (OS) (Cox proportional hazards model). Potential predictive markers were identified using a treatment-by-marker interaction term in the Cox model. Results: Non-responders (stable and progressive disease) had a median baseline HIF-1α expression significantly higher than responders (complete and partial response) (1.70 vs. 0.94; IQR 1.05-2.32 vs. 0.70-1.12) (p=0.016) in the B-treated group only. In univariate analysis, the high HIF-1α levels of this group were significantly associated with a shorter PFS (HR=1.96, 95% CI 1.17-3.30) (p=0.011) but not with OS. The HIF-1α-treatment interaction was p=0.088. No significant association was found between the other 4 genes and OR, PFS or OS. The results obtained on the modulation of gene expression during treatment are currently being analyzed. Conclusions: Our preliminary datasuggest that high pre-treatment HIF-1α expression levels could represent a predictive biomarker of resistance to bevacizumab. Partially funded by Roche S.p.A. and the Italian Medicines Agency (AIFA).

Observational cohort study of first-line bevacizumab with oxaliplatin or irinotecan and fluoropyrimidines in metastatic colorectal cancer: HGCSG0802—Analysis of early tumor shrinkage (ETS).

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 753-753 ◽  
Author(s):  
Satoshi Yuki ◽  
Hiroshi Nakatsumi ◽  
Kentaro Sawada ◽  
Takashi Kato ◽  
Takashi Meguro ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Multivariate Analysis ◽  
Metastatic Colorectal Cancer ◽  
Univariate Analysis ◽  
First Line ◽  
Factors Associated ◽  
Early Tumor Shrinkage ◽  
Significant Difference ◽  
Early Tumor ◽  
Line Chemotherapy

753 Background: It was reported that early tumor shrinkage (ETS) was associated with better overall survival (OS) in patients (pts) with metastatic colorectal cancer (mCRC) receiving first line chemotherapy. We investigated association of ETS with progression-free survival (PFS) and OS in pts with mCRC treated with first-line bevacizumab (BV)-based chemotherapy (HGCSG0802). Methods: The objective of HGCSG0802 was to evaluate PFS, OS, response rate (RR), safety and so on. The key eligibility criteria were evaluable lesions, older than 20 years old, ECOG PS 0-2. This analysis evaluated the association of ETS at 8 weeks from the start of chemotherapy with pts characteristics, PFS and OS. To identify factors associated with ETS, if there were clinical variables with p < 0.2 in univariate analysis, we planned a multivariate analysis using the logistic regression model. To identify predictive and prognostic factors, a multivariate analysis was performed using Cox proportional hazard model with backward elimination for variables with p < 0.2 in univariate analysis. Results: Of 108 pts (the full analysis set), 99 pts were evaluable for ETS. Sixty-eight pts (68.7%) had ETS ≥20%. The pts characteristics between ETS ≥20% (ETS) and <20% (Non-ETS) were well balanced. In univariate analysis to identify factors associated with ETS, there were no clinical variables with p < 0.2. The median PFS and OS were 7.3/18.3 months in Non-ETS versus 10.0/25.2 months in ETS (HR 0.529; p=0.006 and HR 0.627; p=0.107). In multivariate analysis for PFS and OS, although there was no significant difference between ETS and Non-ETS for OS (HR 0.709; p=0.186), there was significant difference for PFS (HR 0.524; p=0.006). Conclusions: ETS was observed in 68.7% (68/99) and non-ETS in 31.3% (31/99) of patients with metastatic colorectal cancer received bevacizumab combined first line chemotherapy. In univariate analysis, it could not identify any factors associated with ETS. In the results of multivariate analysis, ETS showed an independent predictive impact, but not prognostic impact. Clinical trial information: UMIN000018935.

scholarly journals An Insight into Deficient Mismatch Repair Colorectal Cancer Screening in a Romanian Population—A Bi-Institutional Pilot Study

Medicina ◽  
2021 ◽  
Vol 57 (8) ◽  
pp. 847
Author(s):  
Cristina Lungulescu ◽  
Vlad Mihai Croitoru ◽  
Simona Ruxandra Volovat ◽  
Irina Mihaela Cazacu ◽  
Adina Turcu-Stiolica ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Multivariate Analysis ◽  
Microsatellite Instability ◽  
Mismatch Repair ◽  
Univariate Analysis ◽  
Tumor Stage ◽  
Immune Checkpoints ◽  
P Value ◽  
Regional Variability ◽  
Formalin Fixed Paraffin Embedded

Background and Objectives: Colorectal cancer (CRC) can be classified as mismatch-repair-deficient (dMMR) with high levels of microsatellite instability (MSI-H), or mismatch-repair-proficient (pMMR) and microsatellite stable (MSS). Approximately 15% of patients have microsatellite instability (MSI). MSI-H tumors are associated with a high mutation burden. Monoclonal antibodies that block immune checkpoints can induce long-term durable responses in some patients. Pembrolizumab is the first checkpoint inhibitor approved in the EU to treat dMMR–MSI-H metastatic CRC. Materials and Methods: Our study assesses the regional variability of MSI-H colorectal cancer tumors in Romania. Formalin-fixed, paraffin-embedded (FFPE) tissue blocks containing tumor samples from 90 patients diagnosed with colorectal cancer were collected from two tertiary referral Oncology Centers from Romania. Tissues were examined for the expression loss of MMR proteins (MLH1, PMS2, MSH2, MSH6) using immunohistochemistry or MSI status using polymerase chain reaction (PCR), respectively. Results: MSI-H was detected in 19 (21.1%) patients. MSI-H was located more in ascending colon (36.8% vs. 9.9%, p-value = 0.0039) and less in sigmoid (5.3% vs. 33.8%, p-value = 0.0136) than MSS patients. Most patients were stage II for MSI-H (42.1%) as well as for MSS (56.3%), with significant more G1 (40.9% vs. 15.8%, p-value = 0.0427) for MSS patients. Gender, N stage, and M stage were identified as significant prognostic factors in multivariate analysis. MSI status was not a statistically significant predictor neither in univariate analysis nor multivariate analysis. Conclusion: Considering the efficacy of PD-1 inhibitor in metastatic CRC with MSI-H or dMMR, and its recent approval in EU, it is increasingly important to understand the prevalence across tumor stage, histology, and demographics, since our study displayed higher regional MSI-H prevalence (21%) compared to the literature.

FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN KEJADIAN BBLR DI RUMAH SAKIT UMUM DAERAH PALEMBANG BARI TAHUN 2013

2019 ◽  
Vol 4 (2) ◽  
Author(s):  
Juliana Widyastuti Wahyuningsih Juliana Widyastuti Wahyuningsih
Keyword(s):  
Birth Weight ◽  
Mortality Rate ◽  
Low Birth Weight ◽  
Random Sampling ◽  
Maternal Age ◽  
Univariate Analysis ◽  
Infant Mortality Rate ◽  
Survey Method ◽  
P Value ◽  
Chi Square

ABSTRACT   Low birth weight (LBW) infants with birth weight is less than 2500 grams, regardless of gestational age. Statistically showed 90 % incidence of LBW obtained in developing countries with a mortality rate 35 times higher tinggi.Di South Sumatra Province Infant Mortality Rate ( IMR ) is 29 per 1,000 live births. In Palembang BARI hospitals incidence of LBW in 2013 amounted to 317 cases . The purpose of this study is to determine is there a relationship between the factors of age, education, and parity with the incidence of Low Birth Weight in Palembang BARI hospitals in 2013. This study used survey method crosss sectional analytic approach. The study population was all women who gave birth and was admitted to hospital obstetrics Palembang BARI installations in 2013 amounted to 901. This research was conducted in February 2014. Samples were taken with a random sampling method sistematic. Analyze data using statistical test Chi - Square. Results of univariate analysis of this study showed that 193 (69.4 %) of the respondents had low birth weight, and 85 (30.6 %) respondents had BBLN. 63 (22.7 %) of respondents with a high risk of maternal age and 215 (77.3 %) of respondents with a low risk of maternal age. 157 (56.5 %) respondents with low education mothers and 121 (43.5 %) of respondents with higher education mothers. 48 (17.3 %) respondents with high parity mothers and 230 (82.7 %) respondents with low parity mothers. So the bivariate analysis showed no significant association between maternal age with the incidence of LBW with P value = 0.035, no significant association between education and the incidence of LBW with P value = 0.006, and no significant relationship between the incidence of low birth weight with parity P value = 0.041. It is recommended for health care workers (midwives) hospital in order to be used as material information regarding the occurrence of LBW and as an input as well as the evaluation of success in good health or when needed to do counseling and care of LBW, especially to mothers who give birth to low birth weight baby.   ABSTRAK Berat badan lahir rendah (BBLR) adalah bayi dengan berat lahir kurang dari 2500 gram tanpa memandang masa gestasi. Secara statistik menunjukkan 90% kejadian BBLR didapatkan di negara berkembang dengan angka kematiannya 35 kali lebih tinggi.Di Propinsi Sumatera Selatan Angka Kematian Bayi (AKB) sebesar 29 per 1.000 kelahiran hidup. Di RSUD Palembang BARI Tahun 2013 angka kejadian BBLR berjumlah 317 kasus. Tujuan Penelitian ini adalah untuk mengetahui adakah hubungan antara faktor umur, pendidikan, dan paritas dengan kejadian Berat Badan Lahir Rendah di RSUD Palembang BARI Tahun 2013. Penelitian ini menggunakan metode survey analitik dengan pendekatan crosss sectional. Populasi penelitian ini adalah semua ibu yang melahirkan dan dirawat inap di instalasi kebidanan RSUD Palembang BARI Tahun 2013 berjumlah 901. Penelitian ini dilakukan pada bulan Februari 2014. Sampel penelitian diambil dengan metode sistematic random sampling. Analisa data menggunakan uji statistik Chi – Square. Hasil penelitian analisis univariat ini menunjukkan bahwa 193 (69,4%) responden mengalami BBLR, dan 85 (30,6%) responden mengalami BBLN. 63 (22,7%) responden dengan umur ibu resiko tinggi dan 215 (77,3%) responden dengan umur ibu resiko rendah. 157 (56,5%) responden dengan ibu pendidikan rendah dan 121 (43,5%) responden dengan ibu pendidikan tinggi. 48 (17,3%) reponden dengan ibu paritas tinggi dan 230 (82,7%) responden dengan ibu paritas rendah. Sehingga analisa bivariat menunjukkan ada hubungan yang bermakna antara umur ibu dengan kejadian BBLR dengan P value = 0,035, ada hubungan yang bermakna antara pendidikan dengan kejadian BBLR dengan P value = 0,006 dan ada hubungan yang bermakna antara paritas dengan kejadian BBLR dengan P value = 0,041. Disarankan bagi petugas kesehatan (bidan) rumah sakit agar dapat dijadikan sebagai bahan informasi mengenai terjadinya BBLR dan sebagai bahan masukan serta evaluasi keberhasilan dalam pelayanan kesehatan yang baik atau bila perlu dilakukannya penyuluhan serta asuhan  tentang BBLR khususnya kepada ibu yang melahirkan Bayi dengan BBLR.  

Metastatic Colorectal Cancer: Prognostic and Predictive Factors

2020 ◽  
Vol 27 (17) ◽  
pp. 2779-2791 ◽  
Author(s):  
Anna Nappi ◽  
Guglielmo Nasti ◽  
Carmela Romano ◽  
Massimiliano Berretta ◽  
Alessandro Ottaiano
Keyword(s):  
Colorectal Cancer ◽  
Metastatic Colorectal Cancer ◽  
Predictive Factors ◽  
Cancer Biology ◽  
Clinical Course ◽  
Molecular Signatures ◽  
Biological Drugs ◽  
The Third ◽  
Therapeutic Context ◽  
Prognostic And Predictive Factors

: Colorectal cancer represents the third most frequently occurring cancer worldwide. In the last decade, the survival of patients affected by metastatic colorectal cancer (mCRC) has improved through the introduction of biological drugs. However, in this new and dynamic therapeutic context, research about prognostic and predictive factors is important to guide the oncologists to effective therapies as well as to improve the understanding of colorectal cancer biology. Their identification is an intensive area of research and our future goal will be to depict tumour-specific "molecular signatures" in order to predict the clinical course of the disease and the best treatments. : In this report, we describe clinical, pathological and molecular biomarkers that can play a role as prognostic or predictive factors in mCRC.

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