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Issue: December 10, 2015
December 10, 2015
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C-reactive protein predicted prognosis in metastatic colorectal cancer

Issue: December 10, 2015
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Elevated C-reactive protein appeared associated with impaired prognosis in patients with metastatic colorectal cancer, according to an analysis of data from the randomized, phase 3 NORDIC–VII study.

C-reactive protein (CRP) demonstrated a significance comparable to other markers of systemic inflammatory response, results showed.

Further, in this patient population — randomly assigned oxaliplatin (Eloxatin, Sanofi) with or without cetuximab (Erbitux, ImClone) as a first-line treatment — CRP was strongly correlated with interleukin 6 levels and could serve as a marker for plasma IL-6.

Maria Thomsen, MD, of Oslo University Hospital in Norway, and colleagues used Kaplan-Meier plots, log-rank tests and Cox proportional hazards models to analyze the influence of varied systemic inflammatory response markers — modified Glasgow Prognostic Score, derived Neutrophil Lymphocyte Ratio, and platelet and CRP levels — on survival in 374 patients.

The investigators also studied the relationship between CRP, IL-6, and RAS and BRAF mutation status. This analysis included 393 patients.

The researchers determined the prognostic significance of CRP was at least as good as the systemic inflammatory response markers, and they selected CRP and IL-6 for further investigation.

Thomsen and colleagues observed strong correlation between log-transformed CRP and IL-6 (r = 0.661, P < .001). Further, the researchers observed an association between increased CRP prior to treatment and impaired survival.

Median OS was inversely proportional to CRP levels (HR = 1.34; 95% CI, 1.22-1.48) and median PFS trended in a similar direction (HR = 1.21; 95% CI, 1.1-1.33):

  • CRP less than or equal to 10 mg/L — OS = 24.3 months, PFS = 8.9 months;
  • CRP between 11 and 30 mg/L — OS = 20.6 months, PFS = 7.6 months;
  • CRP between 31 and 60 mg/L — OS = 17.1 months, PFS = 8.2 months; and
  • CRP greater than 60 mg/L — OS = 12.3 months, PFS = 6.6 months.

CRP levels appeared to have similar influence on prognosis in subgroups based on RAS and BRAF mutation status. – by Allegra Tiver

Reference:

Thomsen M, et al. Abstract 2060.

Disclosure: HemOnc Today was unable to confirm the researchers’ financial disclosures at the time of reporting.

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