Final results of the CAVE trial in RAS wild type metastatic colorectal cancer patients treated with cetuximab plus avelumab as rechallenge therapy: Neutrophil to lymphocyte ratio predicts survival

医学 阿维鲁单抗 内科学 西妥昔单抗 结直肠癌 肿瘤科 淋巴细胞 中性粒细胞与淋巴细胞比率 癌症 免疫疗法 无容量
作者
Davide Ciardiello,Vincenzo Famiglietti,Stefania Napolitano,Lucia Esposito,Filippo Pietrantonio,Antonio Avallone,Evaristo Maiello,Chiara Cremolini,Teresa Troiani,Erika Martinelli,Fortunato Ciardiello,Giulia Martini
出处
期刊:Clinical Colorectal Cancer [Elsevier BV]
卷期号:21 (2): 141-148 被引量:15
标识
DOI:10.1016/j.clcc.2022.01.005
摘要

Abstract

Background: High neutrophil-to-lymphocyte ratio (NLR) is a poor prognostic factor in metastatic colorectal cancer (mCRC). Here we provide final results of CAVE mCRC trial, of cetuximab plus avelumab rechallenge in chemo-refractory mCRC patients and investigated the predictive role of NLR. Methods: All the 77 patients enrolled were included in the analysis. A cut-off of 3 was used to correlate baseline NLR with with overall survival (OS) and with progression free survival (PFS), in intention to treat (ITT) and in circulating tumor DNA (ctDNA) RAS/BRAF Wild Type (WT) patients. Results: In ITT population, NLR <3 (49%) group had median overall survival (mOS) of 17.8 months, versus 8.9 months in NLR ≥ 3 group (51%) [HR 0.50, (CI 95% 0.3-0.8), P=0.006]. Median progression free survival (mPFS) was 3.9 months in NLR <3 group and 3.5 months in NLR≥3 [HR 0.79, (CI 95% 0.5-1.24), P=0.3]. In ctDNA RAS/BRAF WT population, mOS was 22 months in NLR <3 group (48%), versus 8.9 months in NLR ≥3 group (52%), [HR 0.38, (CI 95% 0.19-0.75), P=0.005]. A trend towards increased mPFS was observed in patients with NLR <3 versus NLR ≥3: 5.3 versus 3.6 months [HR: 0.79, (CI 95% 0.44-1.4), p=0.43]. In contrast, NLR did not correlate either with PFS or OS in ctDNA RAS/BRAF mutated patients. Conclusion: In the exploratory analysis of the CAVE mCRC trial, baseline NLR <3 significantly correlated with improved survival and may represent a potential predictive biomarker of cetuximab plus avelumab rechallenge activity in ctDNA RAS/BRAF WT patients, that must be confirmed in randomized studies.
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