Abstract No. 169 Aspartate aminotransferase-lymphocyte ratio: predictive value in metastatic colorectal patients undergoing radioembolization

Abstract

While aspartate aminotransferase-lymphocyte ratio (ALRI) has been found to be prognostic in metastatic colorectal (mCRC) patients undergoing systemic therapy, little data is available regarding its utility in patients undergoing radioembolization. The purpose of this study was to evaluate the usefulness of ALRI in predicting radiologic response and overall survival (OS) following radioembolization for mCRC patients. Between January 1, 2014, and December 31, 2019, a total of 42 patients who underwent radioembolization for the treatment of mCRC were reviewed. The patient’s electronic medical records were evaluated for pre and post procedural laboratory values as well as radiologic response according to the European Association for the Study of the Liver (EASL) criteria. Overall radiologic response (ORR) was defined as those who showed a partial or complete response. Survival was measured from the initial radioembolization to time of death. Patients were separated into cohorts utilizing an ALRI of 65. The cohort consisted of 50% (21/42) women and 50% (21/42) men with an average age of 59.1 ± 13.8 years. The average pretreatment ALRI was 65.2 ± 68.9. When comparing those who had an ORR to those who did not there was not a significant difference in ALRI between the two groups (63.3 ± 83.1 vs 51.7 ± 47.9, P = 0.32). While the OS was longer for those with an ALRI < 65 (1.31 ± 1.46 years) as compared to those with an ALRI ≥65 (0.85 ± 0.55 years) it was not significantly so (P = 0.09). Of those patients with both pre and post TACE ALRI values, those that demonstrated a decrease in ALRI did not differ in OS from those who had an increase in ALRI (1.21 ± 1.24 vs 0.55 ± 0.18 years, P = 0.16). However, those who had an increase in ALRI following radioembolization were more likely to have an ORR as compared to those with a decrease in ALRI (13/21 (61.9%) vs 0/5 (0%), P = 0.05). While ALRI did not seem to predict OS in mCRC patients, an increase in ALRI, an indirect measure of systemic inflammation, corresponded to improved radiologic responses. This is an interesting and unexpected finding.