The Predictive Role of Circulating Inflammatory Biomarkers in the Response to Cetuximab-Based Therapy for Unresectable Stage IV Metastatic Colorectal Cancer

Author(s) :

Alexandru Necula 1,2 , Andrei Belu3, Claudia Cristina Burz1,3

1 “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania

2  Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland

3   “Prof. Dr. Ion Chiricuta” Institute of Oncology, Cluj-Napoca, Romania

Corresponding author: Alexandru Necula, Email:

Published: Volume IV, Issue 1, 1 May 2024, -



May 1, 2024 0 Comments


Background: Our retrospective single-center study aimed to assess the value of the  inflammatory biomarkers in predicting the response  to  5-fluorouracil/folinic acid-based chemotherapy and Anti-EGFR monoclonal antibodies (Cetuximab) in stage IV unresectable metastatic colorectal cancer (mCRC) patients

Material & Methods: We conducted a retrospective study on a series of 38 consecutively patients with stage IV mCRC patients who received first-line therapy (FOLFOX/FOLFIRI Doublet Chemotherapy + Cetuximab) between 2014 and 2023. Inclusion criteria encompassed KRAS wild-type status, left-sided colorectal cancer, and availability of response assessment on CT scan up to  3 months after starting the treatment. Chemotherapy response was assessed using RECIST 1.1 criteria. NLR (Neutrophil-to-Lymphocyte Ratio) , and PLR (Platelet-to-Lymphocyte Ratio)  were measured a day prior to first day of therapy and a ROC curve analysis was performed to find the cutoff values able to predict  among responders  (complete or partial response )and non-responders (stable and progressive disease)

Results: ROC curve analysis showed cutoff values for NLR of 1.54 and for PLR of 95.90. High lymphocyte levels tend to lead to a more favorable response, while high neutrophil and platelet levels associate with a worse prognosis.

Conclusion: Our study highlights the role of NLR and PLR as predictive biomarkers in Cetuximab-based therapy for unresectable mCRC, providing valuable insights for clinicians in therapeutic decision-making.

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