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. 2020 Aug;123(3):403-409.
doi: 10.1038/s41416-020-0894-7. Epub 2020 May 19.

The Pan-Immune-Inflammation Value is a new prognostic biomarker in metastatic colorectal cancer: results from a pooled-analysis of the Valentino and TRIBE first-line trials

Giovanni Fucà  1 , Vincenzo Guarini  1 , Carlotta Antoniotti  2   3 , Federica Morano  1 , Roberto Moretto  3 , Salvatore Corallo  1 , Federica Marmorino  2   3 , Sara Lonardi  4 , Lorenza Rimassa  5   6 , Andrea Sartore-Bianchi  7   8 , Beatrice Borelli  2   3 , Marco Tampellini  9 , Sara Bustreo  10 , Matteo Claravezza  11 , Alessandra Boccaccino  2   3 , Roberto Murialdo  12 , Alberto Zaniboni  13 , Gianluca Tomasello  14 , Fotios Loupakis  4 , Vincenzo Adamo  15   16 , Giuseppe Tonini  17 , Enrico Cortesi  18 , Filippo de Braud  1   8 , Chiara Cremolini  2   3 , Filippo Pietrantonio  19   20
Affiliations

The Pan-Immune-Inflammation Value is a new prognostic biomarker in metastatic colorectal cancer: results from a pooled-analysis of the Valentino and TRIBE first-line trials

Giovanni Fucà et al. Br J Cancer. 2020 Aug.

Abstract

Background: Immune-inflammatory biomarkers (IIBs) showed a prognostic relevance in patients with metastatic CRC (mCRC). We aimed at evaluating the prognostic power of a new comprehensive biomarker, the Pan-Immune-Inflammation Value (PIV), in patients with mCRC receiving first-line therapy.

Methods: In the present pooled-analysis, we included patients enrolled in the Valentino and TRIBE trials. PIV was calculated as: (neutrophil count × platelet count × monocyte count)/lymphocyte count. A cut-off was determined using the maximally selected rank statistics method. Generalised boosted regression (GBR), the Kaplan-Meier method and Cox hazards regression models were used for survival analyses.

Results: A total of 438 patients were included. Overall, 208 patients (47%) had a low-baseline PIV and 230 (53%) had a high-baseline PIV. Patients with high PIV experienced a worse PFS (HR, 1.66; 95% CI, 1.36-2.03, P < 0.001) and worse OS (HR, 2.01; 95% CI, 1.57-2.57; P < 0.001) compared to patients with low PIV. PIV outperformed the other IIBs in the GBR model and in the multivariable models.

Conclusion: PIV is a strong predictor of survival outcomes with better performance than other well-known IIBs in patients with mCRC treated with first-line therapy. PIV should be prospectively validated to better stratify mCRC patients undergoing first-line therapy.

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Conflict of interest statement

F.M. reported honoraria from: Servier; travel grants from: Sanofi, Servier. S.L. reported consulting/advisory board fees from: Amgen, Merck–Serono, Lilly; lecture fees from: Roche, Lilly, Bristol-Myers Squibb, Servier, Merck–Serono; research Funding: Amgen, Merck–Serono. L.R. reported consulting/advisory board fees from: Amgen, Arqule, Basilea, Baxter, Bayer, Celgene, Eisai, Exelixis, Hengrui, Incyte, Ipsen, Italfarmaco, Eli Lilly, MSD, Roche, Sanofi, and Sirtex Medical; lecture fees from: AbbVie, AstraZeneca, and Gilead; travel grants from: Arqule and Ipsen. A.S.B. reported consulting/advisory board fees from: Amgen, Bayer, Sanofi; lecture fees from: Amgen, Bayer, Sanofi; travel grants from: Amgen, Bayer, Sanofi. M.C. reported lecture fees from: Sanofi, Aventis, Amgen; travel grants from: Roche, Genentech, Sanofi, Aventis. A.Z. reported consulting/advisory board fees from: Amgen, Servier, Bayer, Merck–Serono; lecture fees from: Servier. F.L. reported consulting/advisory board fees from: Amgen, Sanofi, Bayer; lecturer fees from: Roche, Sanofi, Bayer, Amgen; institutional research funding from: Roche, Merck–Serono, Amgen, Bayer; travel grants from: Roche, Amgen, Merck–Serono. F.d.B. reported receiving honoraria for speaker activities and participation in advisory boards from: Amgen, Inc, Roche, and Novartis International AG. C.C. reported receiving honoraria for speaker activities and participation in advisory boards from: Roche, Amgen, Inc, Bayer AG, and Servier Laboratories; research grants from: Merck–Serono. F.P. reported receiving honoraria for speaker activities and participation in advisory boards from: Sanofi SA, Amgen, Inc, Bayer AG, Merck–Serono, Roche, and Servier Laboratories. All remaining authors have declared no conflicts of interest.

Figures

Fig. 1
Fig. 1
Kaplan–Meier curves for PFS (a) and OS (b) in the overall population according to PIV. Blue lines indicate patients with low PIV whereas yellow lines indicate patients with high PIV. Patients with high PIV had worse survival outcomes compared to patients with low PIV.
Fig. 2
Fig. 2
Bar graph showing the relative influence by generalised boosted regression on PFS (a) and OS (b) of the immune-inflammatory biomarkers analysed. PIV showed the highest relative influence among the biomarkers analysed.
Fig. 3
Fig. 3
Kaplan–Meier curve for PFS and OS according to PIV and treatment arm in the Valentino study (a and b, respectively) and in the TRIBE study (c and d, respectively). PIV was not significantly associated with a differential effect of the two maintenance arms in the Valentino study nor with a differential effect of triplet-based vs doublet-based therapy in the TRIBE study.
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References

    1. National Comprehensive Cancer Network. Colon Cancer (Version 4.2019). http://www.nccn.org/professionals/physician_gls/pdf/colon.pdf. (2019).
    1. Morano F, Corallo S, Lonardi S, Raimondi A, Cremolini C, Rimassa L, et al. Negative hyperselection of patients with RAS and BRAF wild-type metastatic colorectal cancer who received panitumumab-based maintenance therapy. J. Clin. Oncol. 2019;37:3099–3110. doi: 10.1200/JCO.19.01254. - DOI - PMC - PubMed
    1. Terzić J, Grivennikov S, Karin E, Karin M. Inflammation and colon cancer. Gastroenterology. 2010;138:2101–2114.e5. doi: 10.1053/j.gastro.2010.01.058. - DOI - PubMed
    1. Markman JL, Shiao SL. Impact of the immune system and immunotherapy in colorectal cancer. J. Gastrointest. Oncol. 2015;6:208–223. - PMC - PubMed
    1. Dolan RD, McSorley ST, Horgan PG, Laird B, McMillan DC. The role of the systemic inflammatory response in predicting outcomes in patients with advanced inoperable cancer: systematic review and meta-analysis. Crit. Rev. Oncol. Hematol. 2017;116:134–146. doi: 10.1016/j.critrevonc.2017.06.002. - DOI - PubMed

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