A new prognostic factor in patients with recurrent glioblastoma multiforme treated with bevacizumab plus irinotecan: Hemoglobin, albumin, lymphocytes and platelets (HALP) score

Yıl 2023, Cilt: 4 Sayı: 1, 19 - 23, 31.01.2023

Mustafa Korkmaz Melek Karakurt Eryılmaz Mehmet Zahid Koçak Aykut Demirkıran Murat Araz Mustafa Karaağaç Mehmet Artaç

https://doi.org/10.47482/acmr.1175461

Öz

Background: We aimed to investigate whether the HALP score is a prognostic marker in patients with recurrent GBM who were given bevacizumab plus irinotecan.
Methods: We compared the survival of patients followed up in our clinic with the diagnosis of recurrent GBM and treated with bevacizumab plus irinotecan, according to HALP score.
Results: Median PFS and OS were 4.5 (0.9-14.9) and 8 (0.9-21.3) months, respectively. The median PFS of the low HALP score group was 1.85 (1.3-3.37) months, and of the high HALP score group was 4.96 (0.9-14.9) months (p=0.03). The OS of the high HALP score group (9.63 [7.28-11.9]) was statistically higher compared with low HALP score group (2.26 [0.88-3.65]) (p<0.001). In univariate analysis HALP score was a significant prognostic factor; patients with low HALP score had a poorer prognosis than high HALP score (HR: 0.063, p<0.001). The multivariate analysis showed that HALP score (p=0.003), and residual tumor (p=0.029) were significant prognostic factors. In multivariate Cox regression analysis, low HALP score was a significant poor prognostic factor for OS compared with high HALP score (HR: 0.063, p<0.001).
Conclusions: We showed that the HALP score at the start of treatment is an independent prognostic factor for PFS and OS in patients with recurrent GBM treated with bevacizumab plus irinotecan. The HALP score, which can be easily calculated by routine tests before chemotherapy, can be used as a pognostic marker for bevacizumab treatment decision.

Anahtar Kelimeler

Bevacizumab, Glioblastoma multiforme, HALP, Prognostic marker

Kaynakça

• 1- Stupp R, Mason WP, van den Bent MJ, Weller M, Fisher B, et al; European Organisation for Research and Treatment of Cancer Brain Tumor and Radiotherapy Groups; National Cancer Institute of Canada Clinical Trials Group. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med. 2005 Mar 10;352(10):987-996.
• 2- Stupp R, Hegi ME, Mason WP, van den Bent MJ, Taphoorn MJ, et al; European Organisation for Research and Treatment of Cancer Brain Tumour and Radiation Oncology Groups; National Cancer Institute of Canada Clinical Trials Group. Effects of radiotherapy with concomitant and adjuvant temozolomide versus radiotherapy alone on survival in glioblastoma in a randomised phase III study: 5-year analysis of the EORTC-NCIC trial. Lancet Oncol. 2009 May;10(5):459-466.
• 3- Hundsberger T, Reardon DA, Wen PY. Angiogenesis inhibitors in tackling recurrent glioblastoma. Expert Rev Anticancer Ther. 2017 Jun;17(6):507-515.
• 4- Kaka N, Hafazalla K, Samawi H, Simpkin A, Perry J, et al. Progression-Free but No Overall Survival Benefit for Adult Patients with Bevacizumab Therapy for the Treatment of Newly Diagnosed Glioblastoma: A Systematic Review and Meta-Analysis. Cancers (Basel). 2019 Nov 4;11(11):1723.
• 5- Kickingereder P, Wiestler B, Burth S, Wick A, Nowosielski M, et al. Relative cerebral blood volume is a potential predictive imaging biomarker of bevacizumab efficacy in recurrent glioblastoma. Neuro Oncol. 2015 Aug;17(8):1139-1147.
• 6- Carvalho B, Lopes RG, Linhares P, Costa A, Caeiro C, et al. Hypertension and proteinuria as clinical biomarkers of response to bevacizumab in glioblastoma patients. J Neurooncol. 2020 Mar;147(1):109-116.
• 7- Vaios EJ, Winter SF, Muzikansky A, Nahed BV, Dietrich J. Eosinophil and lymphocyte counts predict bevacizumab response and survival in recurrent glioblastoma. Neurooncol Adv. 2020 Mar 11;2(1):vdaa031.
• 8- Chen XL, Xue L, Wang W, Chen HN, Zhang WH, et al. Prognostic significance of the combination of preoperative hemoglobin, albumin, lymphocyte and platelet in patients with gastric carcinoma: a retrospective cohort study. Oncotarget. 2015 Dec 1;6(38):41370-41382.
• 9- Hu SJ, Zhao XK, Song X, Lei LL, Han WL, et al. Preoperative maximal voluntary ventilation, hemoglobin, albumin, lymphocytes and platelets predict postoperative survival in esophageal squamous cell carcinoma. World J Gastroenterol. 2021 Jan 28;27(4):321-335.
• 10- Xu SS, Li S, Xu HX, Li H, Wu CT, et al. Haemoglobin, albumin, lymphocyte and platelet predicts postoperative survival in pancreatic cancer. World J Gastroenterol. 2020 Feb 28;26(8):828-838.
• 11- Jiang H, Li H, Li A, Tang E, Xu D, et al. Preoperative combined hemoglobin, albumin, lymphocyte and platelet levels predict survival in patients with locally advanced colorectal cancer. Oncotarget. 2016 Nov 1;7(44):72076-72083.
• 12- Peng D, Zhang CJ, Tang Q, Zhang L, Yang KW, et al. Prognostic significance of the combination of preoperative hemoglobin and albumin levels and lymphocyte and platelet counts (HALP) in patients with renal cell carcinoma after nephrectomy. BMC Urol. 2018 Mar 15;18(1):20.
• 13- Peng, D., Zhang, Cj., Gong, Yq. Hao H., Guan B. et al. Prognostic significance of HALP (hemoglobin, albumin, lymphocyte and platelet) in patients with bladder cancer after radical cystectomy. Sci Rep 8, 794 (2018).
• 14- Guo Y, Shi D, Zhang J, Mao S, Wang L, et al. The Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) Score is a Novel Significant Prognostic Factor for Patients with Metastatic Prostate Cancer Undergoing Cytoreductive Radical Prostatectomy. J Cancer. 2019 Jan 1;10(1):81-91.
• 15- Kaya C, Caliskan S, Sungur M, Aydın C. HALP score and albumin levels in men with prostate cancer and benign prostate hyperplasia. Int J Clin Pract. 2021 Mar;75(3):e13766.
• 16- Shen XB, Zhang YX, Wang W, Pan YY. The Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) Score in Patients with Small Cell Lung Cancer Before First-Line Treatment with Etoposide and Progression-Free Survival. Med Sci Monit. 2019 Jul 29;25:5630-5639.
• 17- Yang N, Han X, Yu J, Shu W, Qiu F, et al. Hemoglobin, albumin, lymphocyte, and platelet score and neutrophil-to-lymphocyte ratio are novel significant prognostic factors for patients with small-cell lung cancer undergoing chemotherapy. J Cancer Res Ther. 2020 Sep;16(5):1134-1139.
• 18- Feng Y, Wang J, Tan D, Cheng P, Wu A. Relationship between circulating inflammatory factors and glioma risk and prognosis: A meta-analysis. Cancer Med. 2019 Dec;8(17):7454-7468.
• 19- Besiroglu M, Shbair AT, Yasin AI, Topcu A, Turk HM, et al. Systemic Inflammatory Markers for Prediction of Bevacizumab Benefit in Glioblastoma Multiforme. J Coll Physicians Surg Pak. 2021 Jan;31(1):39-44.
• 20- Ghiaseddin A, Peters KB. Use of bevacizumab in recurrent glioblastoma. CNS Oncol. 2015;4(3):157-69.
• 21- Friedman HS, Prados MD, Wen PY, Mikkelsen T, Schiff D, et al. Bevacizumab alone and in combination with irinotecan in recurrent glioblastoma. J Clin Oncol. 2009 Oct 1;27(28):4733-40.