Prognostic role of serum concentrations of high-sensitivity C-reactive protein in patients with metastatic colorectal cancer: results from the ITACa trial

// Andrea Casadei Gardini 1, * , Silvia Carloni 2, * , Emanuela Scarpi 3 , Paolo Maltoni 4 , Romolo M. Dorizzi 4 , Alessandro Passardi 1 , Giovanni Luca Frassineti 1 , Pietro Cortesi 1 , Maria Benedetta Giannini 1 , Giorgia Marisi 2 , Dino Amadori 1 , Alessandro Lucchesi 1 1 Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy 2 Biosciences Laboratory, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy 3 Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy 4 Corelab Unit, AVR Laboratory, Cesena, Italy * These authors contributed equally to this work Correspondence to: Andrea Casadei Gardini, e-mail: andrea.casadei@irst.emr.it Keywords: metastatic colorectal cancer, high-sensitivity C-reactive protein, thrombosis, progression-free survival, overall survival Received: October 15, 2015      Accepted: January 24, 2016      Published: February 03, 2016 ABSTRACT Serum levels of C-reactive protein are (CRP) higher in patients with neoplastic conditions and numerous studies have been performed to clarify the etiologic and prognostic role of the high-sensitivity CRP (hs-CRP) in cancer. Our study was conducted on patients enrolled in the prospective randomized “Italian Trial in Advanced Colorectal Cancer (ITACa)” to assess hs-CRP levels and their impact on overall survival (OS) and progression-free survival (PFS). Serum samples from 132 ITACa patients were collected at baseline and 2 months after starting first-line chemotherapy. The supernatant was immediately transferred to cryovials and stored at –80°C. After thawing, hs-CRP was measured with the Cobas c501 analyzer. High levels of hs-CRP (≥ 13.1 mg/L) were associated with poorer median PFS ( p < 0.0001) and OS ( p < 0.0001) than low hs-CRP levels (< 13.1 mg/L). hs-CRP values in 107 patients were evaluated again after 2 months of therapy, revealing that patients with low hs-CRP levels in both baseline and second serum samples had the best median PFS and OS. Our study confirms the prognostic value of hs-CRP in patients with metastatic colorectal carcinoma.