Pretreatment blood biomarkers predict pathologic responses to neo-CRT in patients with locally advanced rectal cancer

Future Oncol. 2019 Oct;15(28):3233-3242. doi: 10.2217/fon-2019-0389. Epub 2019 Aug 2.

Abstract

Aim: To evaluate the value of pretreatment blood biomarkers in predicting pathologic responses to neoadjuvant chemoradiotherapy (neo-CRT) in patients with locally advanced rectal cancer. Materials & methods: We conducted logistic regression analysis and receiver operating characteristic to assess the predictive value of blood biomarkers. The outcome was defined by the pathologic complete response and good response. Results: Carcinoembryonic antigen (CEA) (p < 0.001), neutrophil-to-lymphocyte ratio (p = 0.024), platelet-to-lymphocyte ratio (p = 0.006) and lymphocyte-to-monocyte ratio (LMR) (p < 0.001) were significant predictors of pathologic complete response, with area under the curve of 0.785, 0.794, 0.740 and 0.913, respectively; CEA (p = 0.007) and LMR (p < 0.001) correlated significantly with good response, with area under the curve of 0.743 and 0.771, respectively. Conclusion: Lower LMR and higher CEA, neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio before treatment could predict poorer pathologic response to neo-CRT in patients with locally advanced rectal cancer.

Keywords: carcinoembryonic antigen; lymphocyte-to-monocyte ratio; neoadjuvant chemoradiotherapy; neutrophil-to-lymphocyte ratio; pathologic response; platelet-to-lymphocyte ratio; predictor; rectal cancer.

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Biomarkers, Tumor / analysis*
  • Capecitabine / administration & dosage
  • Carcinoembryonic Antigen / metabolism
  • Chemoradiotherapy / mortality*
  • Female
  • Fluorouracil / administration & dosage
  • Follow-Up Studies
  • GPI-Linked Proteins / metabolism
  • Humans
  • Leucovorin / administration & dosage
  • Lymphocytes / pathology*
  • Male
  • Middle Aged
  • Neoadjuvant Therapy / mortality*
  • Neutrophils / pathology*
  • Oxaliplatin / administration & dosage
  • Prognosis
  • ROC Curve
  • Rectal Neoplasms / blood
  • Rectal Neoplasms / metabolism
  • Rectal Neoplasms / pathology*
  • Rectal Neoplasms / therapy
  • Retrospective Studies
  • Survival Rate
  • Young Adult

Substances

  • Biomarkers, Tumor
  • CEACAM5 protein, human
  • Carcinoembryonic Antigen
  • GPI-Linked Proteins
  • Oxaliplatin
  • Capecitabine
  • Leucovorin
  • Fluorouracil