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ASCO Annual Meeting
December 18, 2015
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Top Takeaways from ASCO: Inflammation, CRP and metastatic colorectal cancer

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Increased C-reactive protein appeared associated with impaired prognosis in patients with metastatic colorectal cancer involved in the NORDIC–VII study, showing a significance comparable to other markers of systemic inflammatory response.

Further, in this population randomized to oxaliplatin (Eloxatin, Sanofi Aventis) with or without cetuximab (Erbitux, Imclone) as a first-line treatment, C-reactive protein (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 from other institutions analyzed 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 using Kaplan-Meier plots, log-rank tests and Cox Proportional Hazards models.

The investigators also studied the relationship between CRP, IL-6 and RAS and BRAF mutation status; only 393 patients were eligible for this analysis.

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

Strong correlation was seen 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.

On stratification by CRP, 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, 1.10-1.33):

  • CRP ≤ 10; OS = 24.3 months, PFS = 8.9 months
  • CRP between 11 and 30; OS = 20.6 months, PFS = 7.6 months
  • CRP between 31 and 60; OS = 17.1 months, PFS = 8.2 months
  • CRP > 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

For more information: Thomsen M, et al. Abstract 2060. Presented at: ASCO Annual Meeting. May 29-June 2, 2015; Chicago.

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

 

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