Neutrophil/Lymphocyte and Platelet/lymphocyte Ratios as Predictors of Patient Response to Bevacizumab in Iraqi Patients with Metastatic Colorectal Cancer

Background: Global clinical trials have shown that bevacizumab, along with chemotherapy, is beneficial for people with metastatic colorectal cancer (mCRC). Nevertheless, there isn't a useful biomarker to predict its effectiveness. Objectives: The study's goal was to analyze and evaluate the practical pretreatment biomarker in people with metastatic colorectal cancer (mCRC) to predict bevacizumab efficacy. Methods: This study, which is retrospective, includes 157 patients diagnosed with mCRC who received bevacizumab in association with chemotherapy from three centers in Iraq. The study looked at how clinical data and biomarkers relate to disease control (DC), overall survival (OS), and progression-free survival (PFS). It also looked at how well they could predict these outcomes. The cutoff values of neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) were examined with ROC analysis. Results: For all patients, the median follow-up duration was 12 months. The PLR, NLR and median alkaline phosphatase (ALP) values were considerably lower in disease-control (DC) patients than in non-DC patients. The carcinoembryonic antigen (CEA) baseline level significantly correlated with shorter OS, while the ALP baseline level did not significantly correlate with shorter PFS. Among the clinical data, only multiple organ metastases showed a strong correlation with a shorter PFS and OS. Conclusions: A low pretreatment N/L ratio and P/L ratio might be good predictors of bevacizumab efficacy for metastatic colorectal cancer patients, and it could be clinically useful for choosing responders.