The Influence of Circulating Immune Cell and CA125 Dynamics on Neoadjuvant Therapy Selection for Advanced Ovarian Cancer.

Background and Objectives: Ovarian cancer, including tubal and peritoneal cancer, is the third most common gynecological cancer and the leading cause of death from gynecological malignancies in developed countries. This study explores the prognostic value of the neutrophil-to-lymphocyte ratio (NLR) in determining the optimal duration of neoadjuvant chemotherapy (NACT) for advanced ovarian cancer. It also investigates the correlation between NLR dynamics and the KELIM score, a chemosensitivity marker, to enhance individualized therapeutic strategies. Materials and Methods: A total of 79 patients underwent NACT followed by interval debulking surgery (IDS) or palliative care. The data collected included demographic information, tumor characteristics, treatment modalities, and laboratory parameters. The baseline NLR (NLR-T0) and post-therapeutic NLR (NLR-T1) were calculated, and their variation (NLR∆) was analyzed. The KELIM score was determined using CA-125 values. Results: Patients with a high baseline NLR (≥2.5) had significantly worse progression-free survival (PFS) and overall survival (OS) compared to those with a low NLR (<2.5). A negative NLR∆ was associated with poorer PFS and OS. The KELIM score indicated a more effective treatment response, with higher scores correlating with better outcomes. The majority of patients achieved R0 resection, and those with favorable KELIM scores showed improved survival rates. Conclusions: The NLR is a valuable prognostic marker for assessing treatment response and guiding NACT duration in advanced ovarian cancer.

The Role of KRAS Mutation in Colorectal Cancer-Associated Thrombosis.

Venous thromboembolic events (VTE) are common in patients with colorectal cancer (CRC) and represent a significant contributor to morbidity and mortality. Risk stratification is paramount in deciding the initiation of thromboprophylaxis and is calculated using scores that include tumor location, laboratory values, patient clinical characteristics, and tumor burden. Commonly used risk scores do not include the presence of molecular aberrations as a variable. This retrospective study aims to confirm the link between KRAS-activating mutations and the development of VTE in CRC. A total of 166 patients were included in this study. They were split into two cohorts based on KRAS mutational status. We evaluated the frequency and mean time to VTE development stratified by the presence of KRAS mutations. Patients with mutant KRAS had an odds ratio (OR) of 2.758 for VTE compared to KRAS wild-type patients, with an increased risk of thrombosis being maintained in KRAS mutant patients even after adjusting for other known VTE risk factors. Taking into account the results of this study, KRAS mutation represents an independent risk factor for VTE.

Systemic Neutrophil-to-Lymphocyte Ratio as a Prognostic Biomarker for Colon Cancer.

BACKGROUND AND AIM: Prior research linked a high preoperative neutrophil-to-lymphocyte ratio (NLR) to a worse prognosis in individuals with a variety of malignancies. This study aimed to establish the prognostic and predictive usefulness of preoperative NLR in colorectal cancer (CRC) patients and to identify an appropriate cut-off value for the NLR. We enrolled a total of 195 patients that underwent surgery for stage II and III colorectal cancer that required adjuvant chemotherapy as well as stage IV colorectal cancer patients treated with palliative intent. The mean NLR value was 3.42 +- 2.27. We used a receiver operating characteristic curve to estimate the optimum NLR cut-off value at 3. Patients with a NLR value above 3 were classified as high-NLR, while patients with a NLR below 3 were classified as low-NLR; Results Overall survival (OS) and progression-free survival (PFS) were significantly reduced in high-NLR patients. The overall response rate (ORR) was also lower in high-NLR patients. Conclusions Preoperative NLR is an accessible measurement that seems to have prognostic and predictive value in patients with colorectal cancer.