Systemic inlammatory status at baseline predicts bevacizumab beneit in advanced non-small cell lung cancer patients

Bevacizumab is a humanized anti-VeGF monoclonal antibody able to produce clinical beneit in advanced non-squamous non-small cell lung cancer (nsCLC) patients when combined to chemotherapy. At present, while there is a rising attention to bevacizumab-related adverse events and costs, no clinical or biological markers have been identiied and validated for baseline patient selection. preclinical indings suggest an important role for myeloid-derived inlammatory cells, such as neutrophils and monocytes, in the development of VeGF-independent angiogenesis. We conducted a retrospective analysis to investigate the role of peripheral blood cells count and of an inlammatory index, the neutrophil-tolymphocyte ratio (nLR), as predictors of clinical outcome in nsCLC patients treated with bevacizumab plus chemotherapy. one hundred twelve nsCLC patients treated with chemotherapy ± bevacizumab were retrospectively evaluated for the predictive value of clinical or laboratory parameters correlated with inlammatory status. Univariate analysis revealed that a high number of circulating neutrophils and monocytes as well as a high nLR were associated with shorter progression-free survival (pFs) and overall survival (os) in bevacizumab-treated patients only. We have thus developed a model based on the absence or the presence of at least one of the above-mentioned inlammatory parameters. We found that the absence of all variables strongly correlated with longer pFs and os (9.0 vs. 7.0 mo, hR: 0.39, p = 0.002; and 20.0 vs. 12.0 mo, hR: 0.29, p < 0.001 respectively) only in nsCLC patients treated with bevacizumab plus chemotherapy. our results suggest that a baseline systemic inlammatory status is marker of resistance to bevacizumab treatment in nsCLC patients. .