“Pre-Treatment“ and “Post-Treatment” Systemic Inflammatory Markers: Is There Any Prognostic Role for Metastatic Cervical Cancer on Bevacizumab Containing Treatment?

<i>Background and Objectives</i>: Despite developments in cervical cancer (CC) treatment, an advanced stage is a poor prognostic factor. Cervical cancer is an immunogenic tumor in which viruses, like HPV, play a role in carcinogenesis. Therefore, systemic inflammatory markers (SIMs) may...

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Main Authors: Serkan Yaşar, Ahmet Kadıoğlu, Arif Akyildiz, Nadiye Sever, Mehmet Emin Büyükbayram, Mehmet Bilici, Elanur Karaman, Mehmet Uzun, Murat Bardakcı, Caglar Koseoglu, Irem Bilgetekin, Mehmet Cihan İçli, Alper Türkel, Zafer Arık, Murat Sarı, Tugba Yavuzsen, Mehmet Ali Nahit Sendur, İsmail Erturk, Mutlu Dogan
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Language:English
Published: MDPI AG 2025-06-01
Series:Medicina
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Online Access:https://www.mdpi.com/1648-9144/61/6/1100
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author Serkan Yaşar
Ahmet Kadıoğlu
Arif Akyildiz
Nadiye Sever
Mehmet Emin Büyükbayram
Mehmet Bilici
Elanur Karaman
Mehmet Uzun
Murat Bardakcı
Caglar Koseoglu
Irem Bilgetekin
Mehmet Cihan İçli
Alper Türkel
Zafer Arık
Murat Sarı
Tugba Yavuzsen
Mehmet Ali Nahit Sendur
İsmail Erturk
Mutlu Dogan
author_facet Serkan Yaşar
Ahmet Kadıoğlu
Arif Akyildiz
Nadiye Sever
Mehmet Emin Büyükbayram
Mehmet Bilici
Elanur Karaman
Mehmet Uzun
Murat Bardakcı
Caglar Koseoglu
Irem Bilgetekin
Mehmet Cihan İçli
Alper Türkel
Zafer Arık
Murat Sarı
Tugba Yavuzsen
Mehmet Ali Nahit Sendur
İsmail Erturk
Mutlu Dogan
author_sort Serkan Yaşar
collection DOAJ
description <i>Background and Objectives</i>: Despite developments in cervical cancer (CC) treatment, an advanced stage is a poor prognostic factor. Cervical cancer is an immunogenic tumor in which viruses, like HPV, play a role in carcinogenesis. Therefore, systemic inflammatory markers (SIMs) may have prognostic value. Most studies on SIMs focus on the early stage by evaluating pretreatment levels. This study aims to evaluate the prognostic and predictive values of both pretreatment and post-treatment parameters at the advanced stage, as well as treatment efficacy after progression with first-line treatment. <i>Materials and Methods</i>: A total of 133 advanced-stage CC patients with progression on first-line platin–paclitaxel and bevacizumab were evaluated retrospectively. Demographic and histopathological characteristics were recorded along with treatment details. Pre-treatment baseline blood parameters and post-treatment follow-up values were recorded to calculate SIMs as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and systemic inflammatory response index (SIRI). <i>Results</i>: Median values for SIMs were accepted as cut-off values. Post-treatment values demonstrated stronger predictive power, with pre-treatment SIRI and NLR being significant only in univariate analysis, but not in multivariate analysis. High post-treatment SIRI (>2.1) was correlated with shorter overall survival (OS) and considered a poor prognostic factor. High post-treatment SIRI (>2.1), -SII (>746), and -PLR (>197) emerged as independent prognostic factors for progression-free survival (PFS). Their prognostic values were clearer in the whole population and the metachronous metastatic subgroup. Rechallenge of platinum-based chemotherapy was an option for those who had at least 6 months of PFS with first-line platinum-based chemotherapy. Bevacizumab addition to single-agent or combination regimens led to improved ORR as well. <i>Conclusions</i>: Post-treatment SIRI is a promising prognostic factor for OS, while post-treatment SIRI, SII, and PLR may serve as convenient SIMs for PFS. Platinum-based combination chemotherapy reinduction is a feasible second-line treatment strategy, especially with the addition of bevacizumab.
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spelling doaj-art-b9e116d4234b44a2b9c6dda80048f3402025-08-20T02:20:58ZengMDPI AGMedicina1010-660X1648-91442025-06-01616110010.3390/medicina61061100“Pre-Treatment“ and “Post-Treatment” Systemic Inflammatory Markers: Is There Any Prognostic Role for Metastatic Cervical Cancer on Bevacizumab Containing Treatment?Serkan Yaşar0Ahmet Kadıoğlu1Arif Akyildiz2Nadiye Sever3Mehmet Emin Büyükbayram4Mehmet Bilici5Elanur Karaman6Mehmet Uzun7Murat Bardakcı8Caglar Koseoglu9Irem Bilgetekin10Mehmet Cihan İçli11Alper Türkel12Zafer Arık13Murat Sarı14Tugba Yavuzsen15Mehmet Ali Nahit Sendur16İsmail Erturk17Mutlu Dogan18Department of Medical Oncology, Dr Abdurrahman Yurtaslan Ankara Oncology Training & Research Hospital, University of Health Sciences, 06200 Ankara, TürkiyeDepartment of Medical Oncology, Dr Abdurrahman Yurtaslan Ankara Oncology Training & Research Hospital, University of Health Sciences, 06200 Ankara, TürkiyeDepartment of Medical Oncology, Hacettepe University Cancer Institute, 06230 Ankara, TürkiyeDepartment of Medical Oncology, Faculty of Medicine, Marmara University, 34854 Istanbul, TürkiyeDepartment of Medical Oncology, Faculty of Medicine, Atatürk University, 25240 Erzurum, TürkiyeDepartment of Medical Oncology, Faculty of Medicine, Atatürk University, 25240 Erzurum, TürkiyeDepartment of Medical Oncology, Faculty of Medicine, Karadeniz Technical University, 61080 Trabzon, TürkiyeDepartment of Medical Oncology, Institute of Oncology, Dokuz Eylul University, 35340 İzmir, TürkiyeDepartment of Medical Oncology, Ankara Bilkent City Hospital, 06800 Ankara, TürkiyeDepartment of Medical Oncology, Gulhane Training and Research Hospital, University of Health Sciences, 06200 Ankara, TürkiyeDepartment of Medical Oncology, Memorial Ankara Hospital, 06520 Ankara, TürkiyeDepartment of Medical Oncology, Hacettepe University Cancer Institute, 06230 Ankara, TürkiyeDepartment of Medical Oncology, Dr Abdurrahman Yurtaslan Ankara Oncology Training & Research Hospital, University of Health Sciences, 06200 Ankara, TürkiyeDepartment of Medical Oncology, Hacettepe University Cancer Institute, 06230 Ankara, TürkiyeDepartment of Medical Oncology, Faculty of Medicine, Marmara University, 34854 Istanbul, TürkiyeDepartment of Medical Oncology, Institute of Oncology, Dokuz Eylul University, 35340 İzmir, TürkiyeDepartment of Medical Oncology, Ankara Bilkent City Hospital, 06800 Ankara, TürkiyeDepartment of Medical Oncology, Gulhane Training and Research Hospital, University of Health Sciences, 06200 Ankara, TürkiyeDepartment of Medical Oncology, Dr Abdurrahman Yurtaslan Ankara Oncology Training & Research Hospital, University of Health Sciences, 06200 Ankara, Türkiye<i>Background and Objectives</i>: Despite developments in cervical cancer (CC) treatment, an advanced stage is a poor prognostic factor. Cervical cancer is an immunogenic tumor in which viruses, like HPV, play a role in carcinogenesis. Therefore, systemic inflammatory markers (SIMs) may have prognostic value. Most studies on SIMs focus on the early stage by evaluating pretreatment levels. This study aims to evaluate the prognostic and predictive values of both pretreatment and post-treatment parameters at the advanced stage, as well as treatment efficacy after progression with first-line treatment. <i>Materials and Methods</i>: A total of 133 advanced-stage CC patients with progression on first-line platin–paclitaxel and bevacizumab were evaluated retrospectively. Demographic and histopathological characteristics were recorded along with treatment details. Pre-treatment baseline blood parameters and post-treatment follow-up values were recorded to calculate SIMs as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and systemic inflammatory response index (SIRI). <i>Results</i>: Median values for SIMs were accepted as cut-off values. Post-treatment values demonstrated stronger predictive power, with pre-treatment SIRI and NLR being significant only in univariate analysis, but not in multivariate analysis. High post-treatment SIRI (>2.1) was correlated with shorter overall survival (OS) and considered a poor prognostic factor. High post-treatment SIRI (>2.1), -SII (>746), and -PLR (>197) emerged as independent prognostic factors for progression-free survival (PFS). Their prognostic values were clearer in the whole population and the metachronous metastatic subgroup. Rechallenge of platinum-based chemotherapy was an option for those who had at least 6 months of PFS with first-line platinum-based chemotherapy. Bevacizumab addition to single-agent or combination regimens led to improved ORR as well. <i>Conclusions</i>: Post-treatment SIRI is a promising prognostic factor for OS, while post-treatment SIRI, SII, and PLR may serve as convenient SIMs for PFS. Platinum-based combination chemotherapy reinduction is a feasible second-line treatment strategy, especially with the addition of bevacizumab.https://www.mdpi.com/1648-9144/61/6/1100cervixbevacizumabsystemic inflammatory markers
spellingShingle Serkan Yaşar
Ahmet Kadıoğlu
Arif Akyildiz
Nadiye Sever
Mehmet Emin Büyükbayram
Mehmet Bilici
Elanur Karaman
Mehmet Uzun
Murat Bardakcı
Caglar Koseoglu
Irem Bilgetekin
Mehmet Cihan İçli
Alper Türkel
Zafer Arık
Murat Sarı
Tugba Yavuzsen
Mehmet Ali Nahit Sendur
İsmail Erturk
Mutlu Dogan
“Pre-Treatment“ and “Post-Treatment” Systemic Inflammatory Markers: Is There Any Prognostic Role for Metastatic Cervical Cancer on Bevacizumab Containing Treatment?
Medicina
cervix
bevacizumab
systemic inflammatory markers
title “Pre-Treatment“ and “Post-Treatment” Systemic Inflammatory Markers: Is There Any Prognostic Role for Metastatic Cervical Cancer on Bevacizumab Containing Treatment?
title_full “Pre-Treatment“ and “Post-Treatment” Systemic Inflammatory Markers: Is There Any Prognostic Role for Metastatic Cervical Cancer on Bevacizumab Containing Treatment?
title_fullStr “Pre-Treatment“ and “Post-Treatment” Systemic Inflammatory Markers: Is There Any Prognostic Role for Metastatic Cervical Cancer on Bevacizumab Containing Treatment?
title_full_unstemmed “Pre-Treatment“ and “Post-Treatment” Systemic Inflammatory Markers: Is There Any Prognostic Role for Metastatic Cervical Cancer on Bevacizumab Containing Treatment?
title_short “Pre-Treatment“ and “Post-Treatment” Systemic Inflammatory Markers: Is There Any Prognostic Role for Metastatic Cervical Cancer on Bevacizumab Containing Treatment?
title_sort pre treatment and post treatment systemic inflammatory markers is there any prognostic role for metastatic cervical cancer on bevacizumab containing treatment
topic cervix
bevacizumab
systemic inflammatory markers
url https://www.mdpi.com/1648-9144/61/6/1100
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