Most Read Articles
Natalia Reoutova, 21 Nov 2019

Final analysis of the POEMS (Prevention of Early Menopause) study finds that breast cancer (BC) patients treated with the gonadotrophin-releasing hormone agonist (GnRHa) goserelin, in addition to chemotherapy, are more likely to avoid premature menopause and to become pregnant without negatively impacting disease-related outcomes.

Jairia Dela Cruz, 3 days ago
In breast cancer, especially hormone-negative tumours, an ultrasound-guided core biopsy (CNB) is useful for predicting pathologic complete response (pCR) to chemotherapy and may thus help to avoid surgery for some patients, a study has found.
Christina Lau, 08 Dec 2016

Icotinib improves progression-free survival (PFS) and objective response rate (ORR) vs whole-brain irradiation (WBI) plus chemotherapy in Chinese patients with non-small-cell lung cancer (NSCLC) and brain metastases, according to a phase III study presented recently at the 17th World Conference on Lung Cancer (WCLC).

Christina Lau, 14 Feb 2019
Progress in the treatment of rare cancers has been named Advance of the Year by the American Society of Clinical Oncology (ASCO).

C-reactive protein/albumin ratio a useful prognostic marker in pancreatic cancer

Jairia Dela Cruz
3 days ago

C-reactive protein/albumin ratio (CAR) can provide prognostic information on survival in pancreatic cancer, such that patients with high pretreatment CAR may have poorer overall survival (OS), according to a study presented at the ESMO Asia 2019 Congress.

“Gemcitabine plus nanoparticle albumin-bound–paclitaxel (GnP) and FOLFIRINOX (irinotecan, oxaliplatin and leucovorin-modulated fluorouracil [FFX]) have been shown to improve OS for advanced pancreatic cancer patients,” the investigators said.

To determine the clinical utility of CAR as prognostic factor for patients treated with GnP or FFX, the investigators conducted an exploratory analysis using data from the NAPOLEON study, which examined the efficacy and safety of the said regimens in clinical practice.

A total of 255 patients (median age, 65 years; 62 percent male) with unresectable advanced or recurrent pancreatic cancer who received GnP (n=153) or FFX (n=102) as first-line chemotherapy were included in the analysis. The cut-off value adopted for CAR was 0.54 based on a previous study, and patients with values <0.54 or 0.54 were grouped as CAR-low or CAR-high, respectively.

Several significant predictors of poor overall survival (OS) at the start of first-line chemotherapy emerged on Cox regression analysis. These included undergoing biliary drainage (hazard ratio [HR], 1.76, 95 percent confidence interval [CI], 1.19–2.61; p<0.01), high CAR (HR, 1.52, 95 percent CI, 1.05–2.21; p=0.03) and elevated lactate dehydrogenase level (>240 U/L; HR, 2.10, 95 percent CI, 1.36–3.22; p<0.01). [ESMO Asia 2019, abstract 167P]

In an analysis including 160 patients who initiated second-line chemotherapy, poor OS was associated with the following: poor ECOG performance status (HR, 1.62, 95 percent CI, 1.07–2.47; p=0.02), a high level of carbohydrate antigen 19-9 (HR, 2.14, 95 percent CI, 1.07–4.29; p=0.03) and high CAR (HR, 2.15, 95 percent CI, 1.32–3.49; p<0.01).

Notably, 86 of 140 patients (82.7 percent) in the CAR-high group at initiation of first-line chemotherapy remained with high CAR at the start of second-line treatment.

These findings indicate that “CAR may be [a] useful prognostic factor at the start of both first- and second-line treatment,” the investigators said.

The role of CAR in pancreatic cancer has been widely studied, given that systemic inflammation response is central to the progression of the cancer type. C-reactive protein is a marker of inflammation that has been shown to induce cancer-related production of inflammatory cytokines, whereas albumin is the common marker of nutritional status and relates to chronic inflammation. [Sci Rep 2017;7:2993]

Therefore, the ratio of the two markers reflects potential inflammatory state caused by expansion or invasion in the tumour microenvironment and can be used as a simple and independent prognostic factor in pancreatic cancer. [Medicine 2019;98:e16064]

Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Oncology - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
Natalia Reoutova, 21 Nov 2019

Final analysis of the POEMS (Prevention of Early Menopause) study finds that breast cancer (BC) patients treated with the gonadotrophin-releasing hormone agonist (GnRHa) goserelin, in addition to chemotherapy, are more likely to avoid premature menopause and to become pregnant without negatively impacting disease-related outcomes.

Jairia Dela Cruz, 3 days ago
In breast cancer, especially hormone-negative tumours, an ultrasound-guided core biopsy (CNB) is useful for predicting pathologic complete response (pCR) to chemotherapy and may thus help to avoid surgery for some patients, a study has found.
Christina Lau, 08 Dec 2016

Icotinib improves progression-free survival (PFS) and objective response rate (ORR) vs whole-brain irradiation (WBI) plus chemotherapy in Chinese patients with non-small-cell lung cancer (NSCLC) and brain metastases, according to a phase III study presented recently at the 17th World Conference on Lung Cancer (WCLC).

Christina Lau, 14 Feb 2019
Progress in the treatment of rare cancers has been named Advance of the Year by the American Society of Clinical Oncology (ASCO).