Prognostic role of aspartate aminotransferase-lymphocyte ratio index in patients with metastatic colorectal cancer: Results from the randomized ITACa trial

Andrea Casadei Gardini, Emanuela Scarpi, Elena Orlandi, Davide Tassinari, Silvana Leo, Ilaria Bernardini, Fabio Gelsomino, Stefano Tamberi, Silvia Ruscelli, Roberto Vespignani, Sonia Ronconi, Giovanni Luca Frassineti, Dino Amadori, Alessandro Passardi

Research output: Contribution to journalArticle

Abstract

Background: The aim of this study was to investigate the role of pre-treatment aspartate aminotransferase-lynphocyte ratio (ALRI) as a predictor of prognosis and treatment efficacy in patients with metastatic colorectal cancer (mCRC) enrolled in the prospective multicenter randomized ITACa (Italian Trial in Advanced Colorectal Cancer) trial to receive first-line chemotherapy (CT) + bevacizumab (B) or CT alone. Patients and methods: Patients randomly received CT+B or CT alone as first-line therapy. CT consisted of either FOLFOX4 or FOLFIRI at the clinician’s discretion. Results: Out of the 284 patients enrolled, increased ALRI levels were associated with shorter PFS and OS (p<0.0001). At baseline, median PFS was 10.3 months (95% CI 9.4–12.0) and 8.0 months (95 % CI 6.8–8.9), and median OS was 25.2 months (95 % CI 21.3–30.2) and 18.8 months (95 % CI 16.6–21.7) for patients with low (<14) and high (≥14) ALRI levels, respectively (HR 1.43, 95% CI 1.12–1.82, p=0.004; HR=1.51, 95% CI 1.17–1.96, p<0.001). Interaction tests on ALRI levels and treatment efficacy in the CT+B and the CT groups were statistically significant for PFS (p=0.0003), but not for OS (p=0.228). Conclusion: Our results indicate that ALRI is a good prognostic and predictive marker for mCRC patients candidate for CT+B.

Original languageEnglish
Pages (from-to)5261-5268
Number of pages8
JournalOncoTargets and Therapy
Volume11
DOIs
Publication statusPublished - Jan 1 2018

Keywords

  • Aspartate aminotransferase-lymphocyte ratio index
  • Bevacizumab
  • Clinical outcome
  • First line
  • Metastatic colorectal cancer
  • Prognosis
  • Rectal cancer

ASJC Scopus subject areas

  • Oncology
  • Pharmacology (medical)

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