Author(s) :

Alexandru , Claudia, Andrei .

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Abstract :

Materials and methods A retrospective study of 213 unresectable stage IV metastatic colorectal cancer (mCRC) patients (2014-2023) undergoing first-line therapy (FOLFOX/FOLFIRI Doublet Chemotherapy + Anti-EGFR monoclonal antibodies, Cetuximab) was conducted based on ESMO and ASCO guidelines. Inclusion criteria comprised KRAS wild-type status, left-sided colorectal cancer, completion of Doublet ChT + Cetuximab cycles, and availability of CT examinations at the 3-month follow-up. Exclusion criteria aimed to eliminate factors like active infections or hematologic diseases. NLR and PLR were measured a day before therapy. After applying criteria, 38 patients were selected for further investigation. Chemotherapy response was evaluated at the 3-month checkpoint using RECIST 1.1 criteria, categorizing patients into Response (R), Stable Disease (SD), and Progressive Disease (PD). ROC curve analysis determined cut-off values for NLR (1.54) and PLR (95.90) to distinguish response groups. Stratification into NLR and PLR subsets based on median values involved testing for response differences using appropriate statistical tests. Results Median NLR and PLR values demonstrated an ascending trend from the Response (R) to Progressive Disease (PD) groups, indicating an association between lower NLR and PLR values and a more favorable response. ROC curve analysis suggested potential cut-off values of 1.54 for NLR and 95.90 for PLR, showing trends aligning with existing studies. Although statistical significance wasn't reached, larger sample sizes might validate these insights. Categorizing patients into subsets based on NLR and PLR median values (1.90 and 99, respectively) revealed statistically significant differences in response, supporting their potential as prognostic indicators. Chi-squared tests showed significance in both NLR and PLR subsets (p < 0.0001 and p < 0.03, respectively). Conclusions Our research validates NLR and PLR as effective biomarkers for assessing Cetuximab-based therapy in unresectable mCRC. While not offering absolute precision, their cost-effective and straightforward integration into routine clinical practice underscores their practical value. Moreover, their significance in specific patient populations within diverse healthcare settings enhances their potential utility.

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