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dc.contributor.authorClarke, Stephen John-
dc.contributor.authorBurge, Matthew-
dc.contributor.authorFeeney, Kynan-
dc.contributor.authorGibbs, Peter-
dc.contributor.authorJones, Kristian-
dc.contributor.authorMarx, Gavin-
dc.contributor.authorMolloy, Mark P-
dc.contributor.authorPrice, Timothy-
dc.contributor.authorReece, William H H-
dc.contributor.authorSegelov, Eva-
dc.contributor.authorTebbutt, Niall C-
dc.identifier.citationPloS one 2020; 15(3): e0229900-
dc.description.abstractIn spite of demonstrating prognostic and possibly predictive benefit in retrospective cohorts and meta-analyses of cancer populations, including colorectal cancer (CRC), prospective evaluation of the relationship between neutrophil to lymphocyte ratio (NLR) and treatment outcomes in previously untreated mCRC patients receiving bevacizumab-based therapy has not yet been performed. An open-label, single arm, multi-centre study. Patients received first-line bevacizumab plus XELOX or mFOLFOX6 (Phase-A) and continued bevacizumab plus FOLFIRI beyond first progression (Phase-B). Analyses included the association of NLR with phase A progression free survival (PFS) and overall survival (OS). A sub-study investigated the safety in patients with the primary in situ tumor. An exploratory sub-study examined relationships of circulating proteomic markers with PFS. Phase-A enrolled 128 patients; median age was 64 years (range: 26-84), 70 (55%) were female, 71 (56%) were PS-0 and 51 (40%) had primary in situ tumor. Fifty-three (41%) patients entered Phase-B. The median baseline (b) NLR was 3.2 (range: 1.5-20.4) with 32 (25%) patients having bNLR > 5. The PFS hazard ratio (HR) by bNLR > 5 versus ≤ 5 was 1.4 (95% CI: 0.9-2.2; p = 0.101). The median PFS was 9.2 months (95% CI: 7.9-10.8) for Phase-A and 6.7 months (95% CI: 3.0-8.2) for Phase-B. The HR for OS based on bNLR > 5 versus ≤ 5 was 1.6 (95% CI: 1.0-2.7; p = 0.052). The median OS was 25 months (95% CI: 19.2-29.7) for the full analysis set and 14.9 months for Phase-B. Baseline levels of nine proteomic markers showed a relationship with PFS. Treatment related toxicities were consistent with what has previously been published. There were 4 (3%) instances of GI perforation, of which, 3 (6%) occurred in the primary in situ tumor group. Results from this study are aligned with the previously reported trend towards worse PFS and OS in patients with higher bNLR. NCT01588990; posted May 1, 2012.-
dc.titleThe prognostic role of inflammatory markers in patients with metastatic colorectal cancer treated with bevacizumab: A translational study [ASCENT].-
dc.typeJournal Article-
dc.identifier.journaltitlePloS one-
dc.identifier.affiliationBiostatistics, Covance Pty Ltd, Sydney, Australiaen
dc.identifier.affiliationCancer Services, Royal North Shore Hospital, St Leonards, Australiaen
dc.identifier.affiliationDepartment of Medical Oncology, Austin Health, Heidelberg, Victoria, Australiaen
dc.identifier.affiliationMedical Oncology, St Vincent's Hospital, Darlinghurst, Australiaen
dc.identifier.affiliationHaematology and Medical Oncology, The Queen Elizabeth Hospital and University of Adelaide, Adelaide, Australiaen
dc.identifier.affiliationAustralian Proteome Analysis Facility, Macquarie University, Sydney, Australiaen
dc.identifier.affiliationIntegrated Cancer Centre, Sydney Adventist Hospital, and University of Sydney, Wahroonga, Australiaen
dc.identifier.affiliationMedical Affairs, Roche Products, Pty, Limited, Sydney, Australiaen
dc.identifier.affiliationMedical Oncology, Western Hospital, Footscray, Australiaen
dc.identifier.affiliationDepartment of Oncology, Haematology and Palliative Care, St John of God Murdoch Hospital, Murdoch, Australiaen
dc.identifier.affiliationCancer Care Services, Royal Brisbane and Women Hospital, and University of Queensland, Herston, Australiaen
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