Abstract
The Glasgow Prognostic Score (GPS), combination of C-reactive protein and albumin, has proven its prognostic value in metastatic colorectal cancer (mCRC) patients receiving conventional cytotoxic therapy. More recently, anti-EGFR therapies have been validated in mCRC and roll forward the patients’ overall survival (OS). We aimed to evaluate the prognostic accuracy of the GPS in patients receiving anti-EGFR therapy in addition to conventional chemotherapy. From January 2007 to February 2012, consecutive mCRC patients who received 5-fluorouracil-based chemotherapy plus cetuximab were included in the present analysis. Patients were eligible for the study if they met the following criteria: advanced pathologically proven MCRC, age >18 years, adequate renal function (creatinine clearance >40 ml/min), C-reactive protein and albumin and performance status evaluation before treatment initiation. A total of 49 patients received cetuximab plus 5-fluorouracil-based chemotherapy (colon, n = 34; rectum, n = 15) and were treated with a median follow-up of 35 months (16.5–74.7). Median age was 48 years old. In addition to cetuximab, patients received oxaliplatin- (n = 34, 60 %) or irinotecan (n = 15, 30 %)-based chemotherapy. At time of diagnosis, 55, 29 and 16 % of patients had a GPS of 0 (n = 27), 1 (n = 14) and 2 (n = 8), respectively. Fifty-five, 29 and 14 % of patients add one, two or ≥3 metastatic sites, respectively. Considering two groups (GPS = 0 and GPS ≥1), median progression-free survivals were significantly different (p = 0.0084). Median OS in the GPS 0, 1 and 2 groups were 38.2, 14 and 12.1 months, respectively (p = 0.0093). The results of the present study confirm that the GPS is still a simple and effective prognostic factor in the era of cetuximab therapy in mCRC patients.
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Conflict of interest
Prof. Goldwasser has acted as paid consultant for Bayer Healthcare and Pfizer. Dr. Coriat has acted as paid consultant for Roche, Merck and Novartis. Dr Mir has acted as paid consultant for Roche, Servier, Pfizer and Novartis. The other authors have no conflict of interest to declare.
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Dréanic, J., Maillet, M., Dhooge, M. et al. Prognostic value of the Glasgow Prognostic Score in metastatic colorectal cancer in the era of anti-EGFR therapies. Med Oncol 30, 656 (2013). https://doi.org/10.1007/s12032-013-0656-y
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DOI: https://doi.org/10.1007/s12032-013-0656-y