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Kazuyori T, Tamura N, Kojima A and Kuwano K
Background and objective: Carboplatin, paclitaxel, and bevacizumab (CPB) therapy is a treatment option for non-small cell lung cancer. Factors predicting the survival of patients receiving this therapy were investigated.
Methods: From 2011 to 2016, 41 patients (excluding those positive for EGFR mutation or ALK fusion gene) received first-line CPB therapy. Prognostic factors for progression-free survival (PFS) and overall survival (OS) were investigated by the Cox proportional hazards model.
Results: The median age was 70 years, 38 patients had adenocarcinoma, and 30 patients were men. Eastern Cooperative Oncology Group performance status (PS) was 0 /1 /2 in 10/ 29/2 patients. Overall PFS and OS were 6.4 and 10.9 months, respectively. According to univariate analysis, a neutrophil/lymphocyte ratio (NLR)>3.0 and hypoalbuminemia (serum albumin < 3.5 g/dL) were associated with significantly shorter median PFS and OS (NLR >3.0 vs. not: 6.3 vs. 11.2 months, p=0.00307, and 9.5 months vs. not achieved, p=0.0214; hypoalbuminemia vs. not: 5.5 vs. 9.7 months, p=0.0039, and 6.4 vs. 33.2 months, p= 0.000164). Conversely, a good PS was associated with significantly longer median PFS and OS (PS=0 vs. not: 11.1 vs. 6.1 months, p= 0.00537, and not achieved vs. 9.5 months, p=0.0343). Cox proportional analysis confirmed NLR>3.0 and hypoalbuminemia as poor prognostic factors (NLR>3.0 for PFS: hazard ratio (HR) 2.84, p=0.037; hypoalbuminemia for OS: HR 6.54, p=0.008432). However, good PS was not significant.
Conclusion: In lung cancer patients receiving CPB therapy, the prognosis might be predicted by NLR, hypoalbuminemia, and PS.