Mario Scartozzi1, Andrea Casadei-Gardini2,3, Giulia Orsi4, Francesco Tovoli5,6, Vincenzo Dadduzio7, Caterina Vivaldi8,9, Oronzo Brunetti10, Luca Ielasi5,6, Fabio Conti11, Giulia Rovesti4, Laura Gramantieri12, Mario Domenico Rizzato7,13, Irene Pecora8, Antonella Argentiero10, Federica Teglia5,6, Sara Lonardi7, Francesca Salani8, Alessandro Granito5,6, Vittorina Zagonel7, Giorgia Marisi14, Giuseppe Cabibbo15, Francesco Giuseppe Foschi11, Francesca Benevento5, Alessandro Cucchetti5, Fabio Piscaglia5,6, Stefano Cascinu16,17. 1. Department of Medical Oncology, University Hospital of Cagliari, Cagliari, Italy. 2. Vita-Salute San Rafaele University, Milan, Italy. casadeigardini@gmail.com. 3. Department of Medical Oncology, San Rafaele Scientifc Institute IRCCS, Milan, Italy. casadeigardini@gmail.com. 4. Department of Oncology and Hematology, Division of Oncology, University Hospital of Modena, Via del Pozzo 71, Modena, Italy. 5. Department of Medical and Surgical Sciences - DIMEC, Alma Mater Studiorum-University of Bologna, Bologna, Italy. 6. Division of Internal Medicine, Azienda Ospedaliero-Universitaria di Bologna, via Albertoni 15, Bologna, Italy. 7. Medical Oncology Unit 1, Department of Clinical and Experimental Oncology, Istituto Oncologico Veneto, IRCCS, Padua, Italy. 8. Division of Medical Oncology 2, Pisa University Hospital, Pisa, Italy. 9. Department of Translational Research and New Surgical and Medical Technologies, University of Pisa, Via Savi 6, Pisa, 56126, Italy. 10. Medical Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy. 11. Department of Internal Medicine, Faenza Hospital, AUSL Romagna, Faenza, Italy. 12. Center for Applied Biomedical Research (CRBa), St. Orsola-Malpighi University Hospital, Bologna, Italy. 13. Department of Surgery, Oncology and Gastroenterology, University of Padova, Padua, Italy. 14. Biosciences Laboratory, Istituto Scientifco Romagnolo per lo Studio e la Cura dei Tumori (IRST), IRCCS, Meldola, Italy. 15. Section of Gastroenterology and Hepatology, PROMISE, University of Palermo, Palermo, Italy. 16. Vita-Salute San Rafaele University, Milan, Italy. 17. Department of Medical Oncology, San Rafaele Scientifc Institute IRCCS, Milan, Italy.
Abstract
BACKGROUND: Inflammation is a long-established hallmark of liver fibrosis and carcinogenesis. Eosinophils are emerging as crucial components of the inflammatory process influencing cancer development. The role of blood eosinophils in patients with hepatocellular carcinoma receiving systemic treatment is an unexplored field. OBJECTIVE: The objective of this study was to analyse the prognostic role of the baseline eosinophil count in patients with sorafenib-treated hepatocellular carcinoma. PATIENTS AND METHODS: A training cohort of 92 patients with advanced- or intermediate-stage sorafenib-treated hepatocellular carcinoma and two validation cohorts of 65 and 180 patients were analysed. Overall survival and progression-free survival in relation to baseline eosinophil counts were estimated by the Kaplan-Meier method. Univariate and multivariate analyses were performed. RESULTS: A negative prognostic impact of low baseline eosinophil counts (< 50*109/L) was demonstrated in all cohorts (training cohort: hazard ratio = 50.1, 95% confidence interval 11.6-216.5, p < 0.0001 for low vs high eosinophil counts; first validation cohort: hazard ratio = 4.55, 95% confidence interval 1.24-16.65, p = 0.022; second validation cohort: hazard ratio = 3.21, 95% confidence interval 1.83-5.64, p < 0.0001). Moreover, low eosinophil counts had a negative prognostic role in patients progressing on or intolerant to sorafenib who received second-line regorafenib, but not capecitabine or best supportive care. CONCLUSIONS: Our analysis identified baseline blood eosinophil counts as a new prognostic factor in patients with sorafenib-treated hepatocellular carcinoma. Concerning second-line therapies, eosinophil counts were associated with survival outcomes only in regorafenib-treated patients, suggesting a possible predictive role in this setting.
BACKGROUND: Inflammation is a long-established hallmark of liver fibrosis and carcinogenesis. Eosinophils are emerging as crucial components of the inflammatory process influencing cancer development. The role of blood eosinophils in patients with hepatocellular carcinoma receiving systemic treatment is an unexplored field. OBJECTIVE: The objective of this study was to analyse the prognostic role of the baseline eosinophil count in patients with sorafenib-treated hepatocellular carcinoma. PATIENTS AND METHODS: A training cohort of 92 patients with advanced- or intermediate-stage sorafenib-treated hepatocellular carcinoma and two validation cohorts of 65 and 180 patients were analysed. Overall survival and progression-free survival in relation to baseline eosinophil counts were estimated by the Kaplan-Meier method. Univariate and multivariate analyses were performed. RESULTS: A negative prognostic impact of low baseline eosinophil counts (< 50*109/L) was demonstrated in all cohorts (training cohort: hazard ratio = 50.1, 95% confidence interval 11.6-216.5, p < 0.0001 for low vs high eosinophil counts; first validation cohort: hazard ratio = 4.55, 95% confidence interval 1.24-16.65, p = 0.022; second validation cohort: hazard ratio = 3.21, 95% confidence interval 1.83-5.64, p < 0.0001). Moreover, low eosinophil counts had a negative prognostic role in patients progressing on or intolerant to sorafenib who received second-line regorafenib, but not capecitabine or best supportive care. CONCLUSIONS: Our analysis identified baseline blood eosinophil counts as a new prognostic factor in patients with sorafenib-treated hepatocellular carcinoma. Concerning second-line therapies, eosinophil counts were associated with survival outcomes only in regorafenib-treated patients, suggesting a possible predictive role in this setting.
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Authors: Katarina Kalavska; Zuzana Sestakova; Andrea Mlcakova; Paulina Gronesova; Viera Miskovska; Katarina Rejlekova; Daniela Svetlovska; Zuzana Sycova-Mila; Jana Obertova; Patrik Palacka; Jozef Mardiak; Miroslav Chovanec; Michal Chovanec; Michal Mego Journal: Life (Basel) Date: 2022-05-02
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