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ABSTRACT: Background
We aim to test the hypothesis that high plasma YKL-40 is associated with short progression-free survival (PFS) and overall survival (OS) in patients with metastatic colorectal cancer (mCRC) treated with first-line oxaliplatin and 5-flourouracil with or without cetuximab.Patients and methods
A total of 566 patients in the NORDIC VII Study were randomized 1?1?1 to arm A (Nordic FLOX), arm B (Nordic FLOX + cetuximab), or arm C (Nordic FLOX + cetuximab for 16 weeks followed by cetuximab alone as maintenance therapy). Pretreatment plasma samples were available from 510 patients. Plasma YKL-40 was determined by ELISA and dichotomized according to the age-corrected 95% YKL-40 level in 3130 healthy subjects.Results
Pretreatment plasma YKL-40 was elevated in 204 patients (40%), and median YKL-40 was higher in patients with mCRC than in healthy subjects (age adjusted, P<0.001). Patients with elevated YKL-40 had shorter PFS than patients with normal YKL-40 (7.5 vs. 8.2 months; hazard ratio (HR) ?=?1.27 95% confidence interval (CI) 1.05-1.53 P?=?0.013) and shorter OS (16.8 vs. 23.9 months; HR?=?1.33, 1.04-1.69, P?=?0.024). Multivariate Cox analysis demonstrated that elevated pretreatment YKL-40 was an independent biomarker of short OS (HR?=?1.12, 1.01-1.25, P?=?0.033). The ratio of the updated plasma YKL-40 (i.e. level after 1, 2, 8 weeks of treatment, and at end of treatment compared to the baseline level) was associated with OS (HR?=?1.27, 1.06-1.52, P?=?0.011).Conclusions
Plasma YKL-40 is an independent prognostic biomarker in patients with mCRC treated with first-line oxaliplatin-based therapy alone or combined with cetuximab.
SUBMITTER: Tarpgaard LS
PROVIDER: S-EPMC3912025 | biostudies-literature | 2014
REPOSITORIES: biostudies-literature
Tarpgaard Line S LS Guren Tormod K TK Glimelius Bengt B Christensen Ib J IJ Pfeiffer Per P Kure Elin H EH Sorbye Halfdan H Ikdahl Tone T Yilmaz Mette M Johansen Julia S JS Tveit Kjell Magne KM
PloS one 20140203 2
<h4>Background</h4>We aim to test the hypothesis that high plasma YKL-40 is associated with short progression-free survival (PFS) and overall survival (OS) in patients with metastatic colorectal cancer (mCRC) treated with first-line oxaliplatin and 5-flourouracil with or without cetuximab.<h4>Patients and methods</h4>A total of 566 patients in the NORDIC VII Study were randomized 1∶1∶1 to arm A (Nordic FLOX), arm B (Nordic FLOX + cetuximab), or arm C (Nordic FLOX + cetuximab for 16 weeks followe ...[more]