在进一步的转移性结直肠癌（mCRC）治疗中，中位无进展生存期（PFS）较短，许多患者在任何抗肿瘤治疗中都没有受益，因此应根据最佳支持性护理进行治疗。基于肿瘤炎症标志物的标准实验室检测值的风险评分旨在定义一个具有高治疗效益的患者群，并可能提供肿瘤生物学上的见解。由于雷格非尼在德国市场上因不利的风险-收益比而被撤出，因此对于任何进一步的后续治疗选择，患者的选择至关重要。 我们使用Cox回归分析确定与OS和PFS结果无关的实验室标志物作为独立的预后因素。这些变量的影响通过使用Cox回归分析计算的估计值进行加权。估计器被实施为乘法因子，从而得到一个风险评分。然后通过Cox回归分析确定结果风险值的截断值，得到低风险和高风险亚组。 利用82名患者的数据，可以计算出一个用于识别末线mCRC治疗患者长期生存的风险评分。以下参数在多变量分析中与明显较长的生存期相关：NLR ≤5（p = < 0.001），AP ≤200 U/L（p = 0.001），CRP ≤3.2 mg/dL（p = < 0.001）。以下估计器值用于计算风险评分：NLR：0.132（p = 0.046），AP：0.004（p = 0.014），CRP：0.032（p = 0.039）。将估计器作为乘法因子实施，得到以下风险评分：0.132*NLR + 0.004*AP + 0.032*CRP = 风险值。Cox回归分析结果使得风险值低于1.4的患者分为低风险亚组，而高于1.4的患者分为高风险亚组。在低风险评分组（< 1.4）中，患者在开始雷格非尼治疗后的中位OS为10.5个月。具有高风险评分（> 1.4）的患者在开始雷格非尼治疗后只存活3.3个月（n = 43，p < 0.001，HR = 3.76）。 该复合风险评分可将患者分为两个预后亚组，其特点是标准实验室检测值。具有系统性炎症迹象的患者，表现为NLR、AP和CRP升高，具有较高的复合风险评分和显著较短的总生存期。尽管该评分需要在更大的队列中进行前瞻性验证，但可用于分层患者进行进一步的后续治疗研究。 © 2023 The Author(s). Published by S. Karger AG, Basel.

In further-line mCRC treatment, median progression-free survival (PFS) is rather short, and many patients do not benefit from any antitumor treatment and should therefore be treated according to best-supportive care. A risk score based on standard laboratory values using markers of tumor inflammation aims to define a patient cohort with high treatment benefit and might offer insights into tumor biology. As regorafenib has been dropped off the German market due to an unfavorable risk-benefit ratio, patient selection is key for any further-line treatment option.We used Cox regression analysis to determine laboratory markers that are independent prognostic factors of OS and PFS outcome. The influence of these variables was weighted using an estimator, which was calculated using Cox regression analysis. The estimators were implemented as multiplication factors, resulting in a risk score. A cut-off value for the resulting risk values was then determined via Cox regression analysis resulting in a low- and high-risk subgroup.Using data of 82 patients, a risk score identifying long-term survival in patients with last-line mCRC treatment could be calculated. The following parameters were associated with significantly longer survival in multivariate analysis: NLR ≤5 (p = <0.001), AP ≤200 U/L (p = 0.001), CRP ≤3.2 mg/dL (p = <0.001). The following estimator values were used to calculate a risk score: NLR: 0.132 (p = 0.046), AP: 0.004 (p = 0.014), and CRP: 0.032 (p = 0.039). Implementing the estimators as multiplication factors yielded the following risk score: 0.132*NLR + 0.004*AP + 0.032*CRP = Risk value. Cox regression resulted in low- and high-risk subgroups with risk values below and above 1.4, respectively. In the group with a low-risk score (<1.4), patients had a median OS of 10.5 months after initiating regorafenib. Patients with a high-risk score (>1.4) survived only 3.3 months after starting therapy with regorafenib (n = 43, p < 0.001, HR = 3.76).The presented composite risk score stratifies patients into two prognostic subgroups characterized by standard laboratory values. Patients with signs of systemic inflammation characterized by elevated NLR, AP, and CRP have a high composite risk score and a significant shorter overall survival. Although this score needs to be prospectively validated in larger cohorts, it may be used to stratify patients suitable for further-line treatment studies.© 2023 The Author(s). Published by S. Karger AG, Basel.