Systemic Inflammatory Markers for Prediction of Bevacizumab Benefit in Glioblastoma Multiforme.

Objective: To evaluate the predictive significance of systemic inflammation markers (SIMs) in patients with glioblastoma multiforme (GBM), who were treated with bevacizumab (Beva). Study Design: Descriptive study. Place and Duration of Study: The study was conducted at the Bezmialem Vakif University School of Medicine Hospital, Istanbul, Turkey, from January 2014 to September 2019. Methodology: A total of 107 patients, 49 (45.8%) female and 58 (54.2%) male, were retrospectively included in the study. The cut-off values for the SIMs-C-reactive protein to albumin ratio (CAR), neutrophil to lymphocyte (NLR) platelet to lymphocyte ratio (PLR), and systemic immune-inflammatory index (SIII))-were defined by receiver operating characteristic (ROC) analysis. Overall survival (OS) was plotted using the Kaplan-Meier method and compared using the log-rank test. Cox regression analysis was performed for univariate and multivariate analyses. Results: ROC analysis was performed to determine the optimal prognostic value of each parameter. CAR: 1.32, NLR: 2.9, PLR: 159, and SIII: 785 were determined as cut-off values for predicting OS based on the areas under the curve (AUC) in the ROC analysis. CAR at 0.626, had sensitivity of 67%, and specificity of 71% (p=0.129); NLR at 0.725 had sensitivity of 67%, and specificity of 79% (p=0.007); PLR at 0.675 had sensitivity of 67%, and specificity of 64% (p=0.036); and SIII at 0.685, had sensitivity of 56%, and specificity of 71% (p=0.026). A multivariate analysis demonstrated that CAR (p=0.006) and PLR (p=0.024) were independent prognostic factors for OS in patients with GBM, treated by Beva. Conclusion: The present study's findings suggest that pretreatment CAR and PLR might be an independent predictive marker for patients with GBM, who are treated by Beva.