Inflammatory Indexes as Prognostic and Predictive Factors in Ovarian Cancer Treated with Chemotherapy Alone or Together with Bevacizumab. A Multicenter, Retrospective Analysis by the MITO Group (MITO 24)

A Farolfi, M Petrone, E Scarpi, V Gallà, F Greco, C Casanova, L Longo, G Cormio, M Orditura, A Bologna, L Zavallone, J Ventriglia, E Franzese, V Loizzi, D Giardina, E Pigozzi, Raffaela Cioffi, S Pignata, G Giorda, U de Giorgi

Research output: Contribution to journalArticle

Abstract

Background: The variability in progression-free survival (PFS) and overall survival (OS) among patients with epithelial ovarian cancer (EOC) makes it difficult to reliably predict outcomes. A predictive biomarker of bevacizumab efficacy as first-line therapy in EOC is still lacking. Objective: The MITO group conducted a multicenter, retrospective study (MITO 24) to investigate the role of inflammatory indexes as prognostic factors and predictors of treatment efficacy in FIGO stage III–IV EOC patients treated with first-line chemotherapy alone or in combination with bevacizumab. Patients and Methods: Of the 375 patients recruited, 301 received chemotherapy alone and 74 received chemotherapy with bevacizumab. The pre-treatment neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune inflammation index (SII) were evaluated to identify a potential correlation with PFS and OS in both the overall population and the two treatment arms. Results: In the overall population, the PFS and OS were significantly longer in patients with low inflammatory indexes (p <0.0001). In multivariate analyses, the NLR was significantly associated with OS (p = 0.016), and the PLR was significantly associated with PFS (p = 0.024). Inflammatory indexes were significantly correlated with patient prognosis in the chemotherapy-alone group (p <0.0001). Patients in the chemotherapy with bevacizumab group with a high NLR had a higher PFS and OS (p = 0.026 and p = 0.029, respectively) than those in the chemotherapy-alone group. Conversely, PFS and OS were significantly poorer in patients with a high SII (p = 0.024 and p = 0.017, respectively). Conclusion: Our results suggest that bevacizumab improves clinical outcome in patients with a high NLR but may be detrimental in those with a high SII. © 2018 Springer International Publishing AG, part of Springer Nature
Original languageEnglish
Pages (from-to)469-479
Number of pages11
JournalTargeted Oncology
Volume13
Issue number4
DOIs
Publication statusPublished - 2018

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