Prognostic role of sodium levels in colorectal cancer patients receiving aflibercept plus FOLFIRI

Future Oncol. 2023 Dec;19(38):2537-2546. doi: 10.2217/fon-2023-0610. Epub 2023 Dec 5.

Abstract

Aim: To investigate the impact of natremia in metastatic colorectal cancer (mCRC) patients treated with aflibercept plus folinic acid, 5-fluorouracil, oxaliplatin and irinotecan (FOLFIRI). Patients & methods: A total of 84 mCRC patients receiving aflibercept plus FOLFIRI as second-line treatment were enrolled and divided into two groups based on their median sodium value. Progression-free survival and overall survival were analyzed. Results: Patients with sodium levels ≥140 mEq/l had significantly longer median progression-free survival (4.1 vs 2 months; p < 0.01) and median overall survival (12 vs 7.3 months; p < 0.01) compared with those with lower levels. Conclusion: This study suggests that higher pretreatment serum sodium levels are associated with improved outcomes in mCRC patients receiving aflibercept and FOLFIRI, potentially serving as a prognostic marker to aid treatment management.

Keywords: FOLFIRI; aflibercept; colorectal cancer; overall survival; progression-free survival; sodium value.

Plain language summary

What is this article about? Colorectal cancer (CRC) is a common and deadly disease. Despite advances in treatment options, the prognosis remains poor for patients who progress beyond the first-line therapy. Antiangiogenic therapy, which targets blood vessel growth in tumors, has become an important treatment approach for metastatic CRC (mCRC). Aflibercept is a drug used in combination with chemotherapy to treat mCRC patients who have progressed after initial treatment. However, there is limited knowledge about factors that can predict the effectiveness of this treatment. This study aimed to investigate the relationship between sodium levels and treatment outcomes in 84 mCRC patients receiving aflibercept and chemotherapy as second-line therapy. What were the results? The results showed that patients with baseline sodium levels of ≥140 mEq/l had significantly longer progression-free survival and overall survival compared with patients with lower sodium levels. This finding suggests that baseline serum sodium levels could serve as a prognostic factor for survival outcomes in mCRC patients treated with aflibercept and chemotherapy. Other factors associated with better survival outcomes included longer survival without disease progression after first-line chemotherapy, receiving maintenance treatment with aflibercept and completing more treatment cycles. What do the results of the study mean? This study highlights the potential significance of serum sodium levels as a predictor of treatment effectiveness in mCRC patients. Further research is needed to confirm these findings and better understand the underlying mechanisms. Evaluating serum sodium levels could be a useful tool in predicting outcomes and improving treatment strategies for mCRC patients.

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Camptothecin / therapeutic use
  • Colonic Neoplasms* / etiology
  • Colorectal Neoplasms* / pathology
  • Fluorouracil / therapeutic use
  • Humans
  • Leucovorin / therapeutic use
  • Prognosis
  • Receptors, Vascular Endothelial Growth Factor
  • Recombinant Fusion Proteins / adverse effects
  • Rectal Neoplasms* / etiology
  • Sodium / therapeutic use

Substances

  • aflibercept
  • Camptothecin
  • Receptors, Vascular Endothelial Growth Factor
  • Recombinant Fusion Proteins
  • Fluorouracil
  • Leucovorin
  • Sodium