Effect of prognostic nutritional index on laboratory parameters and survival in metastatic colorectal cancer patients treated with fruquintinib: a retrospective study

Abstract

Objective Fruquintinib, a novel anti-angiogenic targeted drug, has gained widespread application in the treatment of metastatic colorectal cancer. This study aims to investigate the impact of the prognostic nutritional index (PNI) on the safety and survival outcomes of patients undergoing fruquintinib treatment for metastatic colorectal cancer. Methods A cohort of 106 patients with metastatic colorectal cancer, treated with fruquintinib at Zhejiang Cancer Hospital between 2019 and 2023, was included in this study. Clinical and laboratory data were subjected to chi-square and t-tests for analysis. PNI values were calculated using a specific formula. The optimal thresholds (cut-off values) for post-treatment PNI were determined through the ROC curve analysis. Kaplan-Meier analysis and the Log-rank test were employed to evaluate progression-free survival (PFS) and overall survival (OS) based on PNI. Multivariate Cox regression model was used to determine independent prognostic factors which influenced survival time. Results The study enrolled 106 colorectal cancer patients treated with fruquintinib. Stratified PNI analysis revealed significant differences in various indicators between high and low PNI groups after treatment with fruquintinib. Notably, after fruquintinib treatment, the high PNI group demonstrated elevated levels in white blood cells, lymphocytes, basophils, red blood cells, hemoglobin, platelets, total protein, and albumin compared to the low PNI group. The median OS for patients with high PNI values was 467 days, significantly longer than the 182 days observed for patients with low PNI values (P < 0.05). Cox regression analysis identified wild-type total RAS and BRAF, partial response (PR) + stable disease (SD), and high PNI values as influencing factors for OS in colorectal cancer patients. Additionally, PR + SD was an independent influencing factor for PFS in colorectal cancer patients (P < 0.05). Conclusions This study suggests that fuquinitinib can improve the survival of patients with metastatic colorectal cancer. Patients with high levels of PNI have a better prognosis and longer survival time, ensuring the nutritional status of patients can be a help to improve the treatment of fuquinitinib.