Prince of Wales Hospital, University of New South Wales, Cancer Survivors Centre, Sydney, Australia
David Goldstein , Daniel D. Von Hoff , E. Gabriela Chiorean , Michele Reni , Josep Tabernero , Ramesh K. Ramanathan , Abdalla Aly , Marc Botteman , Julia Wilkersen , Sandra Margunato-Debay , Brian Lu , Chrystal Ursula Louis , Markus Frederic Renschler , Desmond Micahel Thomas McGovern , Chee Khoon Lee
Background: Prognostic nomograms have been developed in various cancers, including ovarian, breast, and gastrointestinal; however, there is limited information on nomograms in MPC. The large, phase 3 MPACT study of nab-P + Gem vs Gem alone for the treatment of MPC provides a robust database for the development of a nomogram to predict OS using baseline patient variables. Methods: A multivariable Cox model was created from MPACT data using factors that were significantly predictive of OS in univariable analysis or considered clinically important (stepwise selection to remain in model). From the Cox model, a nomogram was derived that assigned points equal to the weighted sum of relative significance of each variable. The nomogram was internally validated using bootstrapping, a concordance index (c-index), and calibration plots. Results: Data from all 861 pts were used. Seven of the 34 considered variables were retained in the multivariable analysis (Table; all factors significant at the P< 0.01 level, except for analgesic use [P = 0.07]). The resulting nomogram was able to distinguish low (n = 216), medium (n = 430), and high (n = 215) risk groups (c-index: 0.69; CI: 0.67-0.71) with median OS values of 12.9, 8.2, and 3.7 months, respectively. Calibration curves showed that the nomogram’s predicted probabilities were mostly consistent with observed probabilities for 6-, 9-, and 12-month OS. Conclusions: Treatment arm, Karnofsky performance status (KPS), neutrophil-to-lymphocyte ratio (NLR), albumin level, sum of longest tumor diameters (SLD), and presence of liver metastasis were the key predictors of OS. This nomogram, which will be presented in visual format in the final presentation, may help physicians and pts make informed treatment decisions. Clinical trial information: NCT00844649
Variablea | HR | CI |
---|---|---|
Treatment arm | 1.56 | 1.34-1.82 |
NLR | 1.05 | 1.04-1.07 |
Albumin | 0.94 | 0.92-0.95 |
KPS (per 10-unit increase) | 0.97 | 0.96-0.98 |
SLD | 1.02 | 1.01-1.03 |
Presence of liver metastasis | 1.62 | 1.29-2.03 |
Analgesic use | 1.16 | 0.99-1.36 |
a Results similar in a sensitivity analysis that excluded CA19-9 non-secretors
Disclaimer
This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org
Abstract Disclosures
2024 ASCO Gastrointestinal Cancers Symposium
First Author: Yan-Shen Shan
2024 ASCO Gastrointestinal Cancers Symposium
First Author: Kazuki Watabe
2023 ASCO Annual Meeting
First Author: Benedikt Westphalen
2023 ASCO Gastrointestinal Cancers Symposium
First Author: Michael J. Pishvaian