Letter to the Editor Received: October 16, 2013 Accepted: October 18, 2013 Published online: December 20, 2013

Oncology 2014;86:44–45 DOI: 10.1159/000356879

A Prognostic Indicator of Survival in Metastatic Colorectal Cancer Patients in the Era of Molecular-Targeted Agents: The Modified Glasgow Prognostic Score Johann Dreanic a Marion Dhooge a Catherine Brezault a Olivier Mir b Stanislas Chaussade a Romain Coriat a, b a

Gastroenterology and Endoscopy Unit and b Center for Research on Angiogenesis Inhibitors (CERIA), Faculté de Médecine, Hôpital Cochin, Université Paris Descartes, Sorbonne Paris Cité, AP-HP, Paris, France

spite their proven efficacy in first-line treatment [5–8]. The study by Inoue et al. [1] reinforced previously published data from Forrest et al. [9] who considered the GPS to be a useful stage-independent predictor for outcome of treatment, but failed to confirm such efficacy in the era of targeted agents. Considering the previous validation of the GPS during the period of conventional therapies, it appears of interest to confirm its efficacy in the era of targeted therapies. With this in mind, we recently reported the value of the GPS using 5-fluorouracilbased chemotherapy in addition to an antiEGFR therapy (cetuximab) in first-line treatment of mCRC patients [10]. Our data reinforced the GPS as an independent indi-

© 2013 S. Karger AG, Basel 0030–2414/13/0861–0044$38.00/0 E-Mail [email protected] www.karger.com/ocl

cator of many therapeutic drugs, including anti-EGFR. The modified GPS could also help to identify unfit mCRC patients in whom first-line chemotherapy regimens should be adapted to comorbidities and poor ECOG performance status. The findings highlighted the importance of the GPS in mCRC patients and deserve further studies to determine the best strategies for treatment choice. Disclosure Statement

The authors have no conflict of interest to declare.

Johann Dréanic, MD Gastroenterology and Endoscopy Unit, Hôpital Cochin 27, rue du Faubourg Saint-Jacques FR–75014 Paris (France) E-Mail johann.dreanic @ cch.aphp.fr

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Dear Editor, We read with great interest the article by Inoue et al. [1] identifying the usefulness of the modified Glasgow Prognostic Score (GPS) as an independent prognostic indicator of survival in patients undergoing multimodality therapy for advanced colorectal cancer (CRC). This biological score has proven its efficiency as a prognostic marker in metastatic CRC (mCRC) [2], in assessing the tolerance of systemic chemotherapy [3] and as a predictor of cancerrelated death after surgery [4]. This retrospective observational study included 245 patients with mCRC and less than 14% (n = 34) were treated with 5-fluorouracil-based cytotoxic chemotherapy in addition to a targeted therapy (bevacizumab, cetuximab or panitumumab), de-

References

Modified GPS in Colorectal Cancer in the Era of Targeted Therapy

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Oncology 2014;86:44–45 DOI: 10.1159/000356879

8 Ranpura V, Hapani S, Wu S: Treatment-related mortality with bevacizumab in cancer patients: a meta-analysis. JAMA 2011;305:487–494. 9 Forrest LM, McMillan DC, McArdle CS, Angerson WJ, Dunlop DJ: Comparison of an inflammation-based prognostic score (GPS) with performance status (ECOG) in patients receiving platinum-based chemotherapy for inoperable non-small-cell lung cancer. Br J Cancer 2004;90:1704–1706. 10 Dréanic J, Maillet M, Dhooge M, Mir O, Brezault C, Goldwasser F, et al: Prognostic value of the Glasgow Prognostic Score in metastatic colorectal cancer in the era of anti-EGFR therapies. Med Oncol 2013;30:656.

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1 Inoue Y, Iwata T, Okugawa Y, Kawamoto A, Hiro J, Toiyama Y, et al: Prognostic significance of a systemic inflammatory response in patients undergoing multimodality therapy for advanced colorectal cancer. Oncology 2013;84:100–107. 2 Proctor MJ, Morrison DS, Talwar D, Balmer SM, O’Reilly DSJ, Foulis AK, et al: An inflammation-based prognostic score (mGPS) predicts cancer survival independent of tumour site: a Glasgow Inflammation Outcome Study. Br J Cancer 2011;104:726–734. 3 Koike Y, Miki C, Okugawa Y, Yokoe T, Toiyama Y, Tanaka K, et al: Preoperative C-reactive protein as a prognostic and therapeutic marker for colorectal cancer. J Surg Oncol 2008;98:540–544.

A prognostic indicator of survival in metastatic colorectal cancer patients in the era of molecular-targeted agents: the modified Glasgow Prognostic Score.

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