Reduction of derived neutrophil-to-lymphocyte ratio after four weeks predicts the outcome of patients receiving second-line chemotherapy for metastatic colorectal cancer

AbstractSystemic inflammation response (SIR) plays a role in predicting prognosis of patients with metastatic colorectal cancer (mCRC). Chemotherapy-induced neutropenia has been suggested as another evaluable prognostic and predictive factor. This is a retrospective analysis of derived neutrophil-to-lymphocyte ratio (dNLR) and its reduction  >  10% after the first cycle of chemotherapy (R10) in a monoinstitutional series of patients with mCRC receiving a first-line and a second-line cytotoxic chemotherapy. The effects of the neutrophil-related variables on overall survival (OS) and on chemotherapy activity were analyzed. One hundred twe nty-eight patients were selected. A relationship of dNLR with OS was evident at both time points, but disappeared after multivariate analysis, whereas R10 was independent prognostic factor only after second-line chemotherapy in multivariate analysis. A dNLR reduction >  10% before the second cycle predicts OS and disease control from second-line chemotherapy in patients with mCRC, in particular among patients with right-sided tumors and synchronous metastases.
Source: Cancer Immunology, Immunotherapy - Category: Cancer & Oncology Source Type: research