Prognostic Value of Routinely Measured Inflammatory Biomarkers in Older Cancer Patients: Pooled Analysis of Three Cohorts

Nadia Oubaya (1, 2, 3) , Pierre Soubeyran (4, 5) , Nicoleta Reinald (1, 3) , Marianne Fonck (4, 5) , Mylene Allain (1, 2) , Sonia Zebachi (1, 3) , Damien Heitz (6, 7) , Marie Laurent (1, 2, 3) , Cecile Delattre (8) , Philippe Caillet (1, 9, 3) , Jerome Dauba (10) , Sylvie Bastuji-Garin (1, 2, 3) , Gilles Albrand (11) , Michael Bringuier (12) , Muriel Rainfray (13) , Etienne Brain (12) , Thomas Grellety (4, 5) , Elena Paillaud (1, 9, 3) , Simone Mathoulin-Pelissier (14, 15, 5) , Carine Bellera (14, 15, 5) , Florence Canoui-Poitrine (1, 2, 3)

1 IMRB - Institut Mondor de Recherche Biomédicale
2 Hôpital Henri Mondor
3 U955 Inserm - UPEC - IMRB - CEPIA/"Clinical Epidemiology And Ageing : Geriatrics, Primary Care and Public Health" [Créteil]
4 ACTION - Actions for OnCogenesis understanding and Target Identification in ONcology
5 Institut Bergonié [Bordeaux]
6 CHU Strasbourg - Centre Hospitalier Universitaire [Strasbourg]
7 Hôpital de Hautepierre [Strasbourg]
8 UNICANCER/ICL - Institut de Cancérologie de Lorraine - Alexis Vautrin [Nancy]
9 HEGP - Hôpital Européen Georges Pompidou [APHP]
10 Centre Hospitalier de Dax
11 CHLS - Centre Hospitalier Lyon Sud [CHU - HCL]
12 Departement d'Oncologie médicale [Paris]
13 CHU Bordeaux
14 BPH - Bordeaux population health
15 CIC Bordeaux

BACKGROUND: The prognostic assessment of older cancer patients is complicated by their heterogeneity. We aimed to assess the prognostic value of routine inflammatory biomarkers. METHODS: A pooled analysis of prospective multicenter cohorts of cancer patients aged >/=70 was performed. We measured CRP and albumin, and calculated Glasgow Prognostic Score (GPS) and CRP/albumin ratio. The GPS has three levels (0 = CRP /= 35 g/L, i.e., normal values; 1 = one abnormal value; 2 = two abnormal values). One-year mortality was assessed using Cox models. Discriminative power was assessed using Harrell's C index (C) and net reclassification improvement (NRI). RESULTS: Overall, 1800 patients were analyzed (mean age: 79 +/- 6; males: 62%; metastases: 38%). The GPS and CRP/albumin ratio were independently associated with mortality in patients not at risk of frailty (hazard ratio [95% confidence interval] = 4.48 [2.03-9.89] for GPS1, 11.64 [4.54-29.81] for GPS2, and 7.15 [3.22-15.90] for CRP/albumin ratio > 0.215) and in patients at risk of frailty (2.45 [1.79-3.34] for GPS1, 3.97 [2.93-5.37] for GPS2, and 2.81 [2.17-3.65] for CRP/albumin ratio > 0.215). The discriminative power of the baseline clinical model (C = 0.82 [0.80-0.83]) was increased by adding GPS (C = 0.84 [0.82-0.85]; NRI events (NRI+) = 10% [2-16]) and CRP/albumin ratio (C = 0.83 [0.82-0.85]; NRI+ = 14% [2-17]). CONCLUSIONS: Routine inflammatory biomarkers add prognostic value to clinical factors in older cancer patients.

Mots clés: Cancer; Older patients; Mortality; Biomarkers

Domaines: Santé publique et épidémiologie

Nadia Oubaya, Pierre Soubeyran, Nicoleta Reinald, Marianne Fonck, Mylene Allain, et al.. Prognostic Value of Routinely Measured Inflammatory Biomarkers in Older Cancer Patients: Pooled Analysis of Three Cohorts. Cancers, 2021, 13 (24), pp.6154. ⟨10.3390/cancers13246154⟩. ⟨hal-03540655⟩