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Int J Cancer. 2016 Nov 15;139(10):2325-35. doi: 10.1002/ijc.30367. Epub 2016 Aug 13.

Prognostic value of baseline seric Syndecan-1 in initially unresectable metastatic colorectal cancer patients: a simple biological score.

Author information

1
Department of Medical Oncology, University Hospital, Besançon, France. mjary@chu-besancon.fr.
2
INSERM, Unit 1098, University of Bourgogne- Franche Comté, Besançon, France. mjary@chu-besancon.fr.
3
Clinical Investigation Center 1431, EFS Bourgogne-Franche Comté, Besançon, France. mjary@chu-besancon.fr.
4
CNRS, Unit 7292, University François-Rabelais, Tours, France.
5
Department of HepatoGastroenterology and Digestive Oncology, University Hospital, Tours, France.
6
Department of HepatoGastroenterology and Digestive Oncology, University Hospital Robert Debré, Reims, France.
7
Department of Medical Oncology, University Hospital, Besançon, France.
8
Clinical Investigation Center 1431, EFS Bourgogne-Franche Comté, Besançon, France.
9
INSERM, Unit 1098, University of Bourgogne- Franche Comté, Besançon, France.
10
Department of Medical Oncology, Leclerc Anticancer Center, Dijon, France.
11
Department of Gastroenterology, University Hospital, Besançon, France.
12
INSERM, Clinical Investigational Center CIC 1415, Tours, France.
13
Department of Digestive Surgery and Liver Transplantation, University Hospital, Besançon, France.
14
Methodological and Quality of Life in Oncology Unit, EA 3181, University Hospital, Besançon, France.

Abstract

In first-line metastatic colorectal cancer (mCRC), baseline prognostic factors allowing death risk and treatment strategy stratification are lacking. Syndecan-1 (CD138) soluble form was never described as a prognostic biomarker in mCRC. We investigated its additional prognostic value for overall survival (OS). mCRC patients with unresectable disease at diagnosis were treated with bevacizumab-based chemotherapy in two independent prospective clinical trials (development set: n = 126, validation set: n = 51, study NCT00489697 and study NCT00544011, respectively). Serums were collected at baseline for CD138 measurement. OS determinants were assessed and, based on the final multivariate model, a prognostic score was proposed. Two independent OS prognostic factors were identified: Lactate Dehydrogenase (LDH) high level (p = 0.0066) and log-CD138 high level (p = 0.0190). The determination of CD138 binary information (cutoff: 75 ng/mL) allowed the assessment of a biological prognostic score with CD138 and LDH values, identifying three risk groups for death (median OS= 38.9, 30.1 and 19.8 months for the low, intermediate and high risk groups, respectively; p < 0.0001). This score had a good discrimination ability (C-index = 0.63). These results were externally confirmed in the validation set. Our study provides robust evidence in favor of the additional baseline soluble CD138 prognostic value for OS, in mCRC patients. A simple biological scoring system is proposed including LDH and CD138 binary status values.

KEYWORDS:

CD138; Syndecan-1; biomarker; colorectal cancer; prognostic score

PMID:
27472156
DOI:
10.1002/ijc.30367
[Indexed for MEDLINE]
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