Impact of Serum Apolipoprotein A-I on Prognosis and Bevacizumab Efficacy in Patients with Metastatic Colorectal Cancer: a Propensity Score-Matched Analysis

Overview

Journal Transl Oncol

Specialty Oncology

Date 2017 Mar 16

PMID 28292509

Citations 14

Authors

Qi Quan

Yuanyuan Huang

Qi Chen

Huijuan Qiu

Qiaozhen Hu

Yuming Rong

Tingwei Li

Liangping Xia

Bei Zhang

Affiliations

Soon will be listed here.

Abstract

Purpose: We aimed to investigate the role of apolipoprotein A-I (ApoA-I) as a predictor of prognosis and treatment efficacy of bevacizumab in patients with metastatic colorectal cancer (mCRC) treated with first-line chemotherapy with or without bevacizumab.

Methods: We conducted a retrospective study on consecutive patients who were diagnosed with mCRC at Sun Yat-sen University Cancer Center. According to their pretreatment ApoA-I level, patients were divided into low- and high-ApoA-I groups. Propensity score-matched method was performed to balance baseline characteristics between two groups. Based on whether they accepted bevacizumab as a first-line therapy, patients were further divided into the chemo + bevacizumab group and the chemo group. Overall survival (OS) and progression-free survival (PFS) were assessed with Kaplan-Meier method, log-rank test, and Cox regression.

Results: The optimal cutoff value for the ApoA-I level was determined to be 1.105 g/l. In the propensity-matched cohort of 508 patients, low ApoA-I was significantly associated with inferior OS (P<.001) and PFS (P<.001) than high ApoA-I. Multivariate analysis showed that ApoA-I level was an independent prognostic maker of OS (P<.001) and PFS (P=.001). PFS (P<.001) in either the high- or low-ApoA-I groups could be extended significantly after the administration of bevacizumab, and patients with a high ApoA-I level also had a better OS in the chemo + bevacizumab group than the chemo group (P=.049).

Conclusions: Patients with a low ApoA-I level have poor prognoses, and they did not display an OS benefit from bevacizumab.

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References

Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M . Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2014; 136(5):E359-86. DOI: 10.1002/ijc.29210. View

Manning E, Ullman J, Leatherman J, Asquith J, Hansen T, Armstrong T . A vascular endothelial growth factor receptor-2 inhibitor enhances antitumor immunity through an immune-based mechanism. Clin Cancer Res. 2007; 13(13):3951-9. DOI: 10.1158/1078-0432.CCR-07-0374. View

Voron T, Marcheteau E, Pernot S, Colussi O, Tartour E, Taieb J . Control of the immune response by pro-angiogenic factors. Front Oncol. 2014; 4:70. PMC: 3980099. DOI: 10.3389/fonc.2014.00070. View

Nosov V, Su F, Amneus M, Birrer M, Robins T, Kotlerman J . Validation of serum biomarkers for detection of early-stage ovarian cancer. Am J Obstet Gynecol. 2009; 200(6):639.e1-5. DOI: 10.1016/j.ajog.2008.12.042. View

. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation. 2002; 106(25):3143-421. View

Lambrechts D, Lenz H, de Haas S, Carmeliet P, Scherer S . Markers of response for the antiangiogenic agent bevacizumab. J Clin Oncol. 2013; 31(9):1219-30. DOI: 10.1200/JCO.2012.46.2762. View

Jiang R, Yang Z, Luo D, Guo L, Sun R, Chen Q . Elevated apolipoprotein A-I levels are associated with favorable prognosis in metastatic nasopharyngeal carcinoma. Med Oncol. 2014; 31(8):80. DOI: 10.1007/s12032-014-0080-y. View

Shrimali R, Yu Z, Theoret M, Chinnasamy D, Restifo N, Rosenberg S . Antiangiogenic agents can increase lymphocyte infiltration into tumor and enhance the effectiveness of adoptive immunotherapy of cancer. Cancer Res. 2010; 70(15):6171-80. PMC: 2912959. DOI: 10.1158/0008-5472.CAN-10-0153. View

Cheng T, Dai X, Zhou D, Lv Y, Miao L . Correlation of apolipoprotein A-I kinetics with survival and response to first-line platinum-based chemotherapy in advanced non-small cell lung cancer. Med Oncol. 2014; 32(1):407. DOI: 10.1007/s12032-014-0407-8. View

10.

Wang X, Dai S, Zhang Z, Liu L, Wang J, Xiao X . Characterization of apolipoprotein A-I as a potential biomarker for cholangiocarcinoma. Eur J Cancer Care (Engl). 2009; 18(6):625-35. DOI: 10.1111/j.1365-2354.2008.00965.x. View

11.

Ferrara N, Hillan K, Gerber H, Novotny W . Discovery and development of bevacizumab, an anti-VEGF antibody for treating cancer. Nat Rev Drug Discov. 2004; 3(5):391-400. DOI: 10.1038/nrd1381. View

12.

Passardi A, Scarpi E, Tamberi S, Cavanna L, Tassinari D, Fontana A . Impact of Pre-Treatment Lactate Dehydrogenase Levels on Prognosis and Bevacizumab Efficacy in Patients with Metastatic Colorectal Cancer. PLoS One. 2015; 10(8):e0134732. PMC: 4526665. DOI: 10.1371/journal.pone.0134732. View

13.

Giantonio B, Catalano P, Meropol N, ODwyer P, Mitchell E, Alberts S . Bevacizumab in combination with oxaliplatin, fluorouracil, and leucovorin (FOLFOX4) for previously treated metastatic colorectal cancer: results from the Eastern Cooperative Oncology Group Study E3200. J Clin Oncol. 2007; 25(12):1539-44. DOI: 10.1200/JCO.2006.09.6305. View

14.

Kim J, Chang J, Yu H, Ahn J, Yum J, Lee S . Inhibition of angiogenesis and angiogenesis-dependent tumor growth by the cryptic kringle fragments of human apolipoprotein(a). J Biol Chem. 2003; 278(31):29000-8. DOI: 10.1074/jbc.M301042200. View

15.

BREWER Jr H, Fairwell T, Larue A, Ronan R, Houser A, Bronzert T . The amino acid sequence of human APOA-I, an apolipoprotein isolated from high density lipoproteins. Biochem Biophys Res Commun. 1978; 80(3):623-30. DOI: 10.1016/0006-291x(78)91614-5. View

16.

Jubb A, Harris A . Biomarkers to predict the clinical efficacy of bevacizumab in cancer. Lancet Oncol. 2010; 11(12):1172-83. DOI: 10.1016/S1470-2045(10)70232-1. View

17.

Gao F, Vasquez S, Su F, Roberts S, Shah N, Grijalva V . L-5F, an apolipoprotein A-I mimetic, inhibits tumor angiogenesis by suppressing VEGF/basic FGF signaling pathways. Integr Biol (Camb). 2011; 3(4):479-89. PMC: 3248743. DOI: 10.1039/c0ib00147c. View

18.

Zamanian-Daryoush M, Lindner D, Tallant T, Wang Z, Buffa J, Klipfell E . The cardioprotective protein apolipoprotein A1 promotes potent anti-tumorigenic effects. J Biol Chem. 2013; 288(29):21237-21252. PMC: 3774392. DOI: 10.1074/jbc.M113.468967. View

19.

Navarro M, Carpintero R, Acin S, Arbones-Mainar J, Calleja L, Carnicer R . Immune-regulation of the apolipoprotein A-I/C-III/A-IV gene cluster in experimental inflammation. Cytokine. 2005; 31(1):52-63. DOI: 10.1016/j.cyto.2005.03.002. View

20.

Feng W, Gao X, McClung G, Zhu S, Ishihara K, Brash J . Methacrylate polymer layers bearing poly(ethylene oxide) and phosphorylcholine side chains as non-fouling surfaces: in vitro interactions with plasma proteins and platelets. Acta Biomater. 2011; 7(10):3692-9. DOI: 10.1016/j.actbio.2011.06.007. View