N-terminal pro-B-type Natriuretic Peptide - a prognostic biomarker in older adults with advanced gastroesophageal cancer: a post-hoc analysis of the GO2 clinical trial

Yuewei Tao; Chim Lang; Russell Petty; Peter S. Hall; Mark Baxter

doi:10.3390/cancers17040601

N-terminal pro-B-type Natriuretic Peptide - a prognostic biomarker in older adults with advanced gastroesophageal cancer: a post-hoc analysis of the GO2 clinical trial

Yuewei Tao, Chim Lang, Russell Petty, Peter S. Hall, Mark Baxter (Lead / Corresponding author)

Research output: Contribution to journal › Article › peer-review

7 Downloads (Pure)

Abstract

Background: Better prognostic biomarkers are needed in older adults with cancer. There are established links between N-terminal pro-B-type Natriuretic Peptide (NT-proBNP) and sarcopenia, and sarcopenia is associated with poorer cancer survival. However, there are limited data regarding baseline NT-proBNP as a biomarker of cancer outcome. The GO2 trial recruited older and/or frail United Kingdom (UK) patients with advanced gastroesophageal cancer and investigated the role of chemotherapy dose de-escalation. Using the GO2 database, we sought to investigate the prognostic role of NT-proBNP as well as the interaction between NT-proBNP and frailty. Methods: This was a post-hoc analysis of a completed clinical trial. Frailty measures included ECOG performance status (PS) and GO2 frailty grouping (based on an assessment of nine geriatric domains). A corrected NT-proBNP (cBNP) was calculated for each patient, adjusting for the upper limit of normal (ULN) reference from each centre. Results: A total of 241 patients were eligible to be included in the analysis. The median age was 76 (range 52–89), 187 (77.6%) were male and 211 (87.6%) had adenocarcinoma. Eighty (33.2%) patients had a baseline NT-proBNP above the local ULN. There was no association between cBNP and ECOG PS (p = 0.36) or the GO2 frailty group (p = 0.58). Those with the highest cBNP (n = 59) had significantly inferior median overall survival: 5.3 months (mos.) vs. 6.8 mos. (medium, n = 120) vs. 8.2 mos. (low, n = 61); HR 1.57 (95% CI; 1.04–2.37), p = 0.031. This was maintained on a Cox regression analysis (HR 1.69, p = 0.01) accounting for the GO2 trial stratification factors. There was no clear association between frailty and NT-proBNP. Conclusions: In this study, NT-proBNP appeared to be prognostic-independent of other factors. Further investigation and validation are needed to confirm our findings and to determine the potential beneficial role of cardioprotective therapy in at-risk patients with cancer identified in this manner.

Original language	English
Article number	601
Number of pages	10
Journal	Cancers
Volume	17
Issue number	4
DOIs	https://doi.org/10.3390/cancers17040601
Publication status	Published - 10 Feb 2025

Keywords

biomarkers
sarcopenia
geriatric oncology
frailty
gastroesophageal cancer

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.3390/cancers17040601Licence: CC BY

Final Published VersionFinal published version, 526 KBLicence: CC BY

1 Finished
1 Active

Multimorbidity, Frailty And An Ageing Cancer Population – Using Health Data To Improve Decision Making
Baxter, M. (Investigator), Lang, C. (Investigator) & Petty, R. (Investigator)
Chief Scientist Office
1/01/25 → 31/12/27
Project: Research
Identifying and Validating Predictive Biomarkers in Advanced Oesophagael Adenocarcinoma - A Springboard to REAListic Medicine (BE-REAL)
Baxter, M. (Investigator)
1/10/20 → 29/02/24
Project: Research

Cite this

@article{43d5b2962a4244439657354a5b3ec9d8,

title = "N-terminal pro-B-type Natriuretic Peptide - a prognostic biomarker in older adults with advanced gastroesophageal cancer: a post-hoc analysis of the GO2 clinical trial",

abstract = "Background: Better prognostic biomarkers are needed in older adults with cancer. There are established links between N-terminal pro-B-type Natriuretic Peptide (NT-proBNP) and sarcopenia, and sarcopenia is associated with poorer cancer survival. However, there are limited data regarding baseline NT-proBNP as a biomarker of cancer outcome. The GO2 trial recruited older and/or frail United Kingdom (UK) patients with advanced gastroesophageal cancer and investigated the role of chemotherapy dose de-escalation. Using the GO2 database, we sought to investigate the prognostic role of NT-proBNP as well as the interaction between NT-proBNP and frailty. Methods: This was a post-hoc analysis of a completed clinical trial. Frailty measures included ECOG performance status (PS) and GO2 frailty grouping (based on an assessment of nine geriatric domains). A corrected NT-proBNP (cBNP) was calculated for each patient, adjusting for the upper limit of normal (ULN) reference from each centre. Results: A total of 241 patients were eligible to be included in the analysis. The median age was 76 (range 52–89), 187 (77.6%) were male and 211 (87.6%) had adenocarcinoma. Eighty (33.2%) patients had a baseline NT-proBNP above the local ULN. There was no association between cBNP and ECOG PS (p = 0.36) or the GO2 frailty group (p = 0.58). Those with the highest cBNP (n = 59) had significantly inferior median overall survival: 5.3 months (mos.) vs. 6.8 mos. (medium, n = 120) vs. 8.2 mos. (low, n = 61); HR 1.57 (95% CI; 1.04–2.37), p = 0.031. This was maintained on a Cox regression analysis (HR 1.69, p = 0.01) accounting for the GO2 trial stratification factors. There was no clear association between frailty and NT-proBNP. Conclusions: In this study, NT-proBNP appeared to be prognostic-independent of other factors. Further investigation and validation are needed to confirm our findings and to determine the potential beneficial role of cardioprotective therapy in at-risk patients with cancer identified in this manner.",

keywords = "biomarkers, sarcopenia, geriatric oncology, frailty, gastroesophageal cancer",

author = "Yuewei Tao and Chim Lang and Russell Petty and Hall, {Peter S.} and Mark Baxter",

note = "{\textcopyright} 2025 by the authors",

year = "2025",

month = feb,

day = "10",

doi = "10.3390/cancers17040601",

language = "English",

volume = "17",

journal = "Cancers",

issn = "2072-6694",

publisher = "MDPI",

number = "4",

}

TY - JOUR

T1 - N-terminal pro-B-type Natriuretic Peptide - a prognostic biomarker in older adults with advanced gastroesophageal cancer

T2 - a post-hoc analysis of the GO2 clinical trial

AU - Tao, Yuewei

AU - Lang, Chim

AU - Petty, Russell

AU - Hall, Peter S.

AU - Baxter, Mark

PY - 2025/2/10

Y1 - 2025/2/10

N2 - Background: Better prognostic biomarkers are needed in older adults with cancer. There are established links between N-terminal pro-B-type Natriuretic Peptide (NT-proBNP) and sarcopenia, and sarcopenia is associated with poorer cancer survival. However, there are limited data regarding baseline NT-proBNP as a biomarker of cancer outcome. The GO2 trial recruited older and/or frail United Kingdom (UK) patients with advanced gastroesophageal cancer and investigated the role of chemotherapy dose de-escalation. Using the GO2 database, we sought to investigate the prognostic role of NT-proBNP as well as the interaction between NT-proBNP and frailty. Methods: This was a post-hoc analysis of a completed clinical trial. Frailty measures included ECOG performance status (PS) and GO2 frailty grouping (based on an assessment of nine geriatric domains). A corrected NT-proBNP (cBNP) was calculated for each patient, adjusting for the upper limit of normal (ULN) reference from each centre. Results: A total of 241 patients were eligible to be included in the analysis. The median age was 76 (range 52–89), 187 (77.6%) were male and 211 (87.6%) had adenocarcinoma. Eighty (33.2%) patients had a baseline NT-proBNP above the local ULN. There was no association between cBNP and ECOG PS (p = 0.36) or the GO2 frailty group (p = 0.58). Those with the highest cBNP (n = 59) had significantly inferior median overall survival: 5.3 months (mos.) vs. 6.8 mos. (medium, n = 120) vs. 8.2 mos. (low, n = 61); HR 1.57 (95% CI; 1.04–2.37), p = 0.031. This was maintained on a Cox regression analysis (HR 1.69, p = 0.01) accounting for the GO2 trial stratification factors. There was no clear association between frailty and NT-proBNP. Conclusions: In this study, NT-proBNP appeared to be prognostic-independent of other factors. Further investigation and validation are needed to confirm our findings and to determine the potential beneficial role of cardioprotective therapy in at-risk patients with cancer identified in this manner.

AB - Background: Better prognostic biomarkers are needed in older adults with cancer. There are established links between N-terminal pro-B-type Natriuretic Peptide (NT-proBNP) and sarcopenia, and sarcopenia is associated with poorer cancer survival. However, there are limited data regarding baseline NT-proBNP as a biomarker of cancer outcome. The GO2 trial recruited older and/or frail United Kingdom (UK) patients with advanced gastroesophageal cancer and investigated the role of chemotherapy dose de-escalation. Using the GO2 database, we sought to investigate the prognostic role of NT-proBNP as well as the interaction between NT-proBNP and frailty. Methods: This was a post-hoc analysis of a completed clinical trial. Frailty measures included ECOG performance status (PS) and GO2 frailty grouping (based on an assessment of nine geriatric domains). A corrected NT-proBNP (cBNP) was calculated for each patient, adjusting for the upper limit of normal (ULN) reference from each centre. Results: A total of 241 patients were eligible to be included in the analysis. The median age was 76 (range 52–89), 187 (77.6%) were male and 211 (87.6%) had adenocarcinoma. Eighty (33.2%) patients had a baseline NT-proBNP above the local ULN. There was no association between cBNP and ECOG PS (p = 0.36) or the GO2 frailty group (p = 0.58). Those with the highest cBNP (n = 59) had significantly inferior median overall survival: 5.3 months (mos.) vs. 6.8 mos. (medium, n = 120) vs. 8.2 mos. (low, n = 61); HR 1.57 (95% CI; 1.04–2.37), p = 0.031. This was maintained on a Cox regression analysis (HR 1.69, p = 0.01) accounting for the GO2 trial stratification factors. There was no clear association between frailty and NT-proBNP. Conclusions: In this study, NT-proBNP appeared to be prognostic-independent of other factors. Further investigation and validation are needed to confirm our findings and to determine the potential beneficial role of cardioprotective therapy in at-risk patients with cancer identified in this manner.

KW - biomarkers

KW - sarcopenia

KW - geriatric oncology

KW - frailty

KW - gastroesophageal cancer

U2 - 10.3390/cancers17040601

DO - 10.3390/cancers17040601

M3 - Article

SN - 2072-6694

VL - 17

JO - Cancers

JF - Cancers

IS - 4

M1 - 601

ER -

N-terminal pro-B-type Natriuretic Peptide - a prognostic biomarker in older adults with advanced gastroesophageal cancer: a post-hoc analysis of the GO2 clinical trial

Abstract

Keywords

UN SDGs

Access to Document

Fingerprint

Projects

Multimorbidity, Frailty And An Ageing Cancer Population – Using Health Data To Improve Decision Making

Identifying and Validating Predictive Biomarkers in Advanced Oesophagael Adenocarcinoma - A Springboard to REAListic Medicine (BE-REAL)

Cite this