Abstract
Background: In the treatment for mCRC, it is essential for understanding the prognosis of each individual patient. GERCOR index(GI) based on performance status and serum LDH has been previously proposed. However, in the salvage setting, the validity of GI has not been reported in patients treated by cetuximab (Cmab)-based chemotherapy.Methods: 269 patients with mCRC treated by Cmab contained chemotherapy were retrospectively registered from 27 centers in Japan. This analysis was included in the KRAS Exon2 wild type patients who were refractory to or intolerant for 5-FU/ irinotecan/ oxaliplatin and were never administered anti-EGFR-antibody. Univariate and multivariate analysis for overall survival (OS) were performed using patient characteristics. Survival analyses were performed with Kaplan-Meier method, log-rank test and Cox proportional hazards model. The analysis was also designed to determine whether the GERCOR index could be extended to progression-free survival (PFS).Results: All data were available for prognostic categorization in 132 patients. Median OS and PFS was 9.8 and 4.3 months. The distribution and median OS / PFS for GI were as follows: low risk (L)(n = 28; 17.9/3.8 months), intermediate risk (I)(n = 52; 12.2/5.0 months), and high risk (H)(n = 52; 7.5/4.1 months). For OS, there was significant difference between L and H (p < 0.001) and between I and H (p < 0.001), but not between L and I (p = 0.076). For PFS, there was significant difference between I and H (p = 0.017), but not between L and I (p = 0.407), and between L and H (p = 0.222). In Cox multivariate analysis, GI showed an independent prognostic impact(L vs I; HR 2.195, p = 0.003 / L vs H; HR 4.028, p < 0.001), but not predictive impact(L vs I; HR 0.987, p = 0.958 / L vs H; HR 1.314, p = 0.268).Conclusions: In this analysis, GI might be a prognostic factor in salvage treatment with Cmab-based regimen, but no effect predicted impact.
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