Gastrointestinal (Noncolorectal) Cancer
Platelet count at baseline (Plt) and outcomes in patients (pts) with advanced hepatocellular carcinoma (HCC) treated with sorafenib (S) in CALGB80802 (Alliance) (C8).
Background: CALGB 80802 study determined that doxorubicin plus sorafenib did not improve survival (OS) compared to sorafenib. The association between platelet count and outcome of patients with HCC is inconsistent and controversial. A retrospective exploratory analysis evaluated the demographics, OS, time to progression (TTP), and progression free survival (PFS) by platelet count in HCC pts treated with sorafenib. Considering the negative outcome of CALGB 80802, the focus herein is on the standard of care sorafenib arm. Methods: The prognostic value of baseline platelet count was evaluated by Cox regression models, adjusting for clinical and pathological factors. Based on an average normal platelet cutoff level, patients were stratified on platelet count <150 and ≥150 × 109/L. Adjusted hazard ratios (HRadj) and 95% confidence intervals (CI) were reported. Results: 61 patients had platelet count <150 × 109/L and 109 had platelet count ≥150 × 109/L. Low platelet count <150 × 109/L was associated with male gender; low T stage, WBC count, ANC, and granulocyte count; high hemoglobin and bilirubin. High platelet count ≥150 × 109/L had shorter PFS and OS that did not reach statistical significance, and was significantly associated with shorter TTP (P=0.04), (Table). Conclusions: For sorafenib, TTP was significantly shorter among pts with platelet count ≥ 150 × 109/L. Platelet count < 150 × 109/L is suggestive of improved OS and PFS compared to pts with platelet count ≥ 150 × 109/L. Platelet count may be a prognostic factor of for patients with advanced HCC and warrants further study. Support: U10CA180821, U10CA180882; U10CA077202, U10CA180820, U10CA180888; Clinical trial information: NCT01015833.
|Platelet× 109/L||Events (number)||Median (months)||HRadj (95% CI)||P|
|≥ 150||93||7.6||1.26 (0.86-1.84)||0.25|
|≥ 150||79||3.6||1.56 ( 2.00-2.41)||0.04|
|≥ 150||100||3.4||1.39 (0.95-2.04)||0.08|