The prognostic value of the systemic inflammatory response in randomised clinical trials in cancer

[pjoshea13]

New study below.

"The prognostic value of the systemic inflammatory response in cancer has been well established in observational studies. This review aims to examine and rationalise the evidence for the role of systemic inflammation based prognostic scores in randomised clinical trials."

"There were 29 trials containing data on 37,020 patients presented in full paper form and 8 trials containing data on 3805 patients presented in abstract form. Most trials were published within the last three years. Seven trials containing data on 6044 patients were published in 2015. Eight trials containing data on 4384 patients were published in 2016. Twelve trials containing data on 27,228 patients were published in 2017. The majority of trials were in advanced inoperable cancer and colorectal cancer was the most common cancer type with 11 articles containing data on 27,909 patients. The GPS/mGPS was shown to have prognostic value in randomised clinical trials in NSCLC, oesophageal cancer, pancreatic cancer, prostate cancer and breast cancer. The NLR/dNLR was shown to have prognostic value in randomised clinical trials in nasopharyngeal cancer, oesophageal cancer, pancreatic cancer, biliary cancer, prostate cancer and multiple cancer types."

I suppose that:

"GPS" = Glasgow Prognostic Score

"mGPS" = Modified Glasgow Prognostic Score

(GPS uses albumin & C-reactive peotein.)

"NLR" = Neutrophil to Lymphocyte Ratio

"dNLR" = derived Neutrophil to Lymphocyte Ratio

As stated in a number of posts, while these tests have prognostic value to doctors, they are a warning to patients to get sub-clinical inflammation under control. That means inhibiting NF-kB via polyphenols or drugs.

-Patrick

ncbi.nlm.nih.gov/pubmed/304...

Crit Rev Oncol Hematol. 2018 Dec;132:130-137. doi: 10.1016/j.critrevonc.2018.09.016. Epub 2018 Oct 5.

The prognostic value of the systemic inflammatory response in randomised clinical trials in cancer: A systematic review.

Dolan RD1, Laird BJA2, Horgan PG2, McMillan DC2.

Author information

Abstract

BACKGROUND:

The prognostic value of the systemic inflammatory response in cancer has been well established in observational studies. This review aims to examine and rationalise the evidence for the role of systemic inflammation based prognostic scores in randomised clinical trials.

METHOD:

An extensive literature review using targeted medical subject headings was carried out in the MEDLINE, EMBASE, and CDSR databases until January 2018. Titles were examined for relevance and after exclusions bibliographies were hand searched to identify additional trials.

RESULTS:

There were 29 trials containing data on 37,020 patients presented in full paper form and 8 trials containing data on 3805 patients presented in abstract form. Most trials were published within the last three years. Seven trials containing data on 6044 patients were published in 2015. Eight trials containing data on 4384 patients were published in 2016. Twelve trials containing data on 27,228 patients were published in 2017. The majority of trials were in advanced inoperable cancer and colorectal cancer was the most common cancer type with 11 articles containing data on 27,909 patients. The GPS/mGPS was shown to have prognostic value in randomised clinical trials in NSCLC, oesophageal cancer, pancreatic cancer, prostate cancer and breast cancer. The NLR/dNLR was shown to have prognostic value in randomised clinical trials in nasopharyngeal cancer, oesophageal cancer, pancreatic cancer, biliary cancer, prostate cancer and multiple cancer types.

CONCLUSION:

The prognostic value of systemic inflammation based prognostic scores has been confirmed in multiple trials and should be incorporated into future prospective randomised clinical trials.

Copyright © 2018. Published by Elsevier B.V.

KEYWORDS:

Cancer; Glasgow prognostic score; Neutrophil lymphocyte ratio; Overall survival; Randomised clinical trials; Systemic inflammation

PMID: 30447918 DOI: 10.1016/j.critrevonc.2018.09.016

[HopingForTheBest1]

Always appreciate your posts. After reading this latest post. I'm not quite sure what the possible implications are for us laymen with metastatic PC. Can you clarify?

[pjoshea13 in reply to HopingForTheBest1]

Subclinical inflammation is associated with worse mortality under a great variety of situations. Cancer is inherently an inflammatory disease due to NF-kB activation.

Standard blood panels give clues relating to inflammation status, e.g. Albumin, Neutrophils, Lymphocytes, & so on. We can reduce inflammation by inhibiting NF-kB activation.

What is the effect on the cancer otherwise? Well, NF-kB causes the creation of scores of pro-survival proteins which can mean that treatments are less successful & resistance sets in earlier.

See:

healthunlocked.com/advanced...

healthunlocked.com/advanced...

healthunlocked.com/advanced....

healthunlocked.com/advanced...

-Patrick