The A.L.A.N. score identifies prognostic classes in advanced biliary cancer patients receiving first-line chemotherapy

Salati, M. et al. (2019) The A.L.A.N. score identifies prognostic classes in advanced biliary cancer patients receiving first-line chemotherapy. European Journal of Cancer, 117, pp. 84-90. (doi: 10.1016/j.ejca.2019.05.030) (PMID:31276980)

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Abstract

Background: Chemotherapy is the mainstay treatment for advanced biliary cancer (ABC). Best supportive care and clinical trials are currently alternative options. The identification of a prognostic score that can be widely applied to daily practice has the potential to better inform clinical management of ABC patients. Methods: A cohort of 123 ABC patients undergoing first-line chemotherapy was used as an exploratory cohort to define the prognostic value of laboratory tests routinely performed in clinical practice. Kaplan–Meier analysis was used to investigate the association between the variables and overall survival (OS). Those variables that were statistically significant at the multivariate analysis were combined in a multiplex score. Performance of the novel prognostic score was confirmed in a validation cohort of 60 ABC patients. Results: Baseline actual neutrophil count, lymphocytes-monocytes ratio, neutrophil-lymphocytes ratio and albumin (A.L.A.N.) correlated with OS at the multivariate analysis in the exploratory cohort. When combined in the multiplex, A.L.A.N. score was able to identify three classes of ABC patients with significantly different OS (high-risk: median OS, 5 months; intermediate-risk: median OS, 12 months and low-risk: median OS, 22 months; p:<0.001). The score performed well in the different subtypes of ABC and was independent of stage, performance status and chemotherapy regimen. The performance of the A.L.A.N. score was confirmed in a validation cohort of cholangiocarcinoma patients (high-risk: median OS, 4.3 months; intermediate-risk: median OS 9.3 months, low-risk: median OS 13 months; p:0.005). Conclusions: The A.L.A.N score can be derived by variables routinely recorded in clinical practice and can provide prognostic assessment of ABC patients considered for first-line treatment.

Item Type:Articles
Keywords:Cholangiocarcinoma, gallbladder cancer, biliary cancer, immunity, inflammation, prognosis, score, survival, gemcitabine, cisplatin.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Braconi, Dr Chiara
Authors: Salati, M., Caputo, F., Cunningham, D., Marcheselli, L., Spallanzani, A., Rimini, M., Gelsomino, F., Reggiani-Bonetti, L., Andrikou, K., Rovinelli, F., Smyth, E., Baratelli, C., Kouvelakis, K., Kalaitzaki, R., Gillbanks, A., Michalarea, V., Cascinu, S., and Braconi, C.
College/School:College of Medical Veterinary and Life Sciences > School of Cancer Sciences
Journal Name:European Journal of Cancer
Publisher:Elsevier
ISSN:0959-8049
ISSN (Online):1879-0852
Published Online:02 July 2019
Copyright Holders:Copyright © 2019 The Authors
First Published:First published in European Journal of Cancer 117:84-90
Publisher Policy:Reproduced under a Creative Commons License

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