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Prognostic Role of Blood Eosinophil Count in Patients with Sorafenib-Treated Hepatocellular Carcinoma

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A Correction to this article was published on 28 October 2020

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Abstract

Background

Inflammation is a long-established hallmark of liver fibrosis and carcinogenesis. Eosinophils are emerging as crucial components of the inflammatory process influencing cancer development. The role of blood eosinophils in patients with hepatocellular carcinoma receiving systemic treatment is an unexplored field.

Objective

The objective of this study was to analyse the prognostic role of the baseline eosinophil count in patients with sorafenib-treated hepatocellular carcinoma.

Patients and Methods

A training cohort of 92 patients with advanced- or intermediate-stage sorafenib-treated hepatocellular carcinoma and two validation cohorts of 65 and 180 patients were analysed. Overall survival and progression-free survival in relation to baseline eosinophil counts were estimated by the Kaplan–Meier method. Univariate and multivariate analyses were performed.

Results

A negative prognostic impact of low baseline eosinophil counts (< 50*109/L) was demonstrated in all cohorts (training cohort: hazard ratio = 50.1, 95% confidence interval 11.6–216.5, p < 0.0001 for low vs high eosinophil counts; first validation cohort: hazard ratio = 4.55, 95% confidence interval 1.24–16.65, p = 0.022; second validation cohort: hazard ratio = 3.21, 95% confidence interval 1.83–5.64, p < 0.0001). Moreover, low eosinophil counts had a negative prognostic role in patients progressing on or intolerant to sorafenib who received second-line regorafenib, but not capecitabine or best supportive care.

Conclusions

Our analysis identified baseline blood eosinophil counts as a new prognostic factor in patients with sorafenib-treated hepatocellular carcinoma. Concerning second-line therapies, eosinophil counts were associated with survival outcomes only in regorafenib-treated patients, suggesting a possible predictive role in this setting.

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Change history

  • 28 October 2020

    An Online First version of this article was made available online at <ExternalRef><RefSource>https://link.springer.com/article/10.1007/s11523-020-00757-3</RefSource><RefTarget Address="https://link.springer.com/article/10.1007/s11523-020-00757-3" TargetType="URL"/></ExternalRef> on 12 October 2020. Errors were subsequently identified in the article, and the following corrections should be noted.

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Author notes

  1. Mario Scartozzi and Andrea Casadei-Gardini are co-last authors.

Authors and Affiliations

  1. Department of Oncology and Hematology, Division of Oncology, University Hospital of Modena, Via del Pozzo 71, Modena, Italy

    Giulia Orsi & Giulia Rovesti

  2. Department of Medical and Surgical Sciences - DIMEC, Alma Mater Studiorum-University of Bologna, Bologna, Italy

    Francesco Tovoli, Luca Ielasi, Federica Teglia, Alessandro Granito, Francesca Benevento, Alessandro Cucchetti & Fabio Piscaglia

  3. Division of Internal Medicine, Azienda Ospedaliero-Universitaria di Bologna, via Albertoni 15, Bologna, Italy

    Francesco Tovoli, Luca Ielasi, Federica Teglia, Alessandro Granito & Fabio Piscaglia

  4. Medical Oncology Unit 1, Department of Clinical and Experimental Oncology, Istituto Oncologico Veneto, IRCCS, Padua, Italy

    Vincenzo Dadduzio, Mario Domenico Rizzato, Sara Lonardi & Vittorina Zagonel

  5. Division of Medical Oncology 2, Pisa University Hospital, Pisa, Italy

    Caterina Vivaldi, Irene Pecora & Francesca Salani

  6. Department of Translational Research and New Surgical and Medical Technologies, University of Pisa, Via Savi 6, Pisa, 56126, Italy

    Caterina Vivaldi

  7. Medical Oncology Unit, IRCCS Istituto Tumori “Giovanni Paolo II”, Bari, Italy

    Oronzo Brunetti & Antonella Argentiero

  8. Department of Internal Medicine, Faenza Hospital, AUSL Romagna, Faenza, Italy

    Fabio Conti & Francesco Giuseppe Foschi

  9. Center for Applied Biomedical Research (CRBa), St. Orsola-Malpighi University Hospital, Bologna, Italy

    Laura Gramantieri

  10. Department of Surgery, Oncology and Gastroenterology, University of Padova, Padua, Italy

    Mario Domenico Rizzato

  11. Biosciences Laboratory, Istituto Scientifco Romagnolo per lo Studio e la Cura dei Tumori (IRST), IRCCS, Meldola, Italy

    Giorgia Marisi

  12. Section of Gastroenterology and Hepatology, PROMISE, University of Palermo, Palermo, Italy

    Giuseppe Cabibbo

  13. Vita-Salute San Rafaele University, Milan, Italy

    Stefano Cascinu & Andrea Casadei-Gardini

  14. Department of Medical Oncology, San Rafaele Scientifc Institute IRCCS, Milan, Italy

    Stefano Cascinu & Andrea Casadei-Gardini

  15. Department of Medical Oncology, University Hospital of Cagliari, Cagliari, Italy

    Mario Scartozzi

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  1. Giulia Orsi
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  2. Francesco Tovoli
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Corresponding author

Correspondence to Andrea Casadei-Gardini.

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Funding

No external funding was used in the conduct of this study or the preparation of this article.

Conflict of Interest

Andrea Casadei-Gardini: consultant for Bayer, EISAI, AstraZeneca and Ipsen. Mario Scartozzi: advisory board for EISAI. Fabio Piscaglia: Esaote (Genova, Italia): Institutional Research Contract; Honoraria: Astrazeneca (Milano, Italia): advisory board, Bayer (Leverkusen, Germania): speaker bureau, advisory board, Bracco (Milano, Italia): speaker bureau, BMS (UK): speaker bureau, La Force Guerbet (Minneapolis, USA): speaker bureau, EISAI (Milano, Italia): speaker bureau, advisory board, GE (Milwaukee, USA): consultant, Tiziana Life Sciences (UK) advisory board, Siemens Healthcare (Germany) advisory board, Alkermes (USA) advisory board, IPSEN (Italy and Greece) speaker bureau). Giulia Orsi, Francesco Tovoli, Vincenzo Dadduzio, Caterina Vivaldi, Oronzo Brunetti, Luca Ielasi, Fabio Conti, Giulia Rovesti, Laura Gramantieri, Mario Domenico Rizzato, Irene Pecora, Antonella Argentiero, Federica Teglia, Sara Lonardi, Francesca Salani, Alessandro Granito, Vittorina Zagonel, Giorgia Marisi, Giuseppe Cabibbo, Francesco Giuseppe Foschi, Francesca Benevento, Alessandro Cucchetti and Stefano Cascinu have no conflicts of interest that are directly relevant to the content of this article.

Ethics Approval

The present research was performed in accordance with the Declaration of Helsinki (6th revision, 2008) and the study protocol was reviewed and approved by the local ethics committee (CEIIAV: comitato etico IRST IRCCS AVR), study number IRST B041, protocol number 5482/v.1 intern code: L3P1192.

Consent to Aarticipate

The study did not involve direct human participants, but only medical records of patients. All participants provided written informed consent to authorise the use of their medical data.

Consent for Publication

The authors declare that the manuscript has not been published previously, in whole or in part, and is not under consideration for publication elsewhere. All authors have approved the manuscript and consent to its publication.

Availability of Data and Material

The datasets generated and/or analysed during the current study are available from the corresponding author on reasonable request.

Author Contributions

Study concept and design: ACG, GO. Data collection: GO, FT, VD, CV, OB, LI, FC, GR, LG, MDR, IP, AA, FT, SL, FS, AG, VZ, GM, GC, FGF, AC, FP, SC, MS, ACG. Experiments and procedures: ACG, GO. Writing and critical revision of the draft: GO, FT, VD, CV, OB, LI, FC, GR, LG, MDR, IP, AA, FT, SL, FS, AG, VZ, GM, GC, FGF, FB, AC, FP, SC, MS, ACG.Study concept and design: ACG, GO. Data collection: GO, FT, VD, CV, OB, LI, FC, GR, LG, MDR, IP, AA, FT, SL, FS, AG, VZ, GM, GC, FGF, AC, FP, SC, MS, ACG. Experiments and procedures: ACG, GO. Writing and critical revision of the draft: GO, FT, VD, CV, OB, LI, FC, GR, LG, MDR, IP, AA, FT, SL, FS, AG, VZ, GM, GC, FGF, FB, AC, FP, SC, MS, ACG.

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Orsi, G., Tovoli, F., Dadduzio, V. et al. Prognostic Role of Blood Eosinophil Count in Patients with Sorafenib-Treated Hepatocellular Carcinoma. Targ Oncol 15, 773–785 (2020). https://doi.org/10.1007/s11523-020-00757-3

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