Prognostic role of neutrophil-to-lymphocyte ratio in castration-resistant prostate cancer patients treated with docetaxel.

Abstract Background Inflammatory cytokine markers, including the neutrophil-to-lymphocyte ratio (NLR), monocyte-lymphocyte ratio, and platelet-to-lymphocyte ratio, play important roles as prognostic markers in several solid malignancies, including prostate cancer. We previously reported the NLR as a poor prognostic marker in bladder cancer, upper-urothelial carcinoma, adrenocortical carcinoma, penile cancer, and prostate cancer. This study examined the importance of the NLR as a prognostic marker for castration-resistant prostate cancer (CRPC) patients who received abiraterone acetate or enzalutamide. Methods A total of 805 prostate cancer patients developed in CRPC status were enrolled in this study. Of these patients, 449 received abiraterone acetate (ABI; 188 cases) or enzalutamide (ENZ; 261 cases) treatment, and the pre-treatment NLR values of these patients were obtained. We investigated the prognosis in those with higher and lower NLR values. Results The median NLR was 2.90, and a receiver operating characteristics analysis suggested a candidate cut-off point of 3.02. The median overall survival (OS) was 17.3 months in the higher NLR group (≥3.02) and 27.3 months in the lower NLR group (< 3.02) (p < 0.0001). This trend was also observed in both the ABI and ENZ groups (ABI: 29.3 vs. 15.1 months; ENZ: NR vs. 19.5 months; p < 0.0001 and < 0.0001, respectively). A multivariate analysis revealed that a higher NLR was an independent risk factor. The NLR value was thus shown to be correlated with the prostate cancer progression. Conclusions A higher NLR was associated with a poorer OS for CRPC patients who received ABI or ENZ. The NLR was positively correlated with prostate cancer progression.

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MP87-02 PROGNOSTIC VALUE OF NEUTROPHIL-TO-LYMPHOCYTE RATIO AND ESTABLISHMENT OF NOVEL RISK STRATIFICATION MODEL IN CASTRATION-RESISTANT PROSTATE CANCER PATIENTS TREATED WITH DOCETAXEL CHEMOTHERAPY

The Journal of Urology ◽

10.1016/j.juro.2015.02.1947 ◽

2015 ◽

Vol 193 (4S) ◽

Cited By ~ 1

Author(s):

Yoshihiro Nakagami ◽

Jun Nakashima ◽

Yoshio Ohno ◽

Ohori Makoto ◽

Masaaki Tachibana

Keyword(s):

Prostate Cancer ◽

Risk Stratification ◽

Cancer Patients ◽

Prognostic Value ◽

Neutrophil To Lymphocyte Ratio ◽

Castration Resistant Prostate Cancer ◽

Lymphocyte Ratio ◽

Castration Resistant ◽

Risk Stratification Model ◽

Docetaxel Chemotherapy

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Pretreatment Neutrophil to Lymphocyte Ratio (NLR) Predicts Prognosis for Castration Resistant Prostate Cancer Patients Underwent Enzalutamide

BioMed Research International ◽

10.1155/2019/9450838 ◽

2019 ◽

Vol 2019 ◽

pp. 1-5 ◽

Cited By ~ 10

Author(s):

Yohei Kumano ◽

Yoriko Hasegawa ◽

Takashi Kawahara ◽

Masato Yasui ◽

Yasuhide Miyoshi ◽

...

Keyword(s):

Prostate Cancer ◽

Multivariate Analysis ◽

Cancer Patients ◽

Neutrophil To Lymphocyte Ratio ◽

Castration Resistant Prostate Cancer ◽

Predictive Tool ◽

Cancer Specific Survival ◽

Lymphocyte Ratio ◽

Factors Associated ◽

Castration Resistant

Introduction. Nearly 80% of advanced prostate cancer patients respond to initial androgen deprivation therapy (ADT). However, ADT does not prevent the progression of prostate cancer over the long term, and the disease eventually progresses to castration-resistant prostate cancer (CRPC). Prior to the development of enzalutamide (ENZ) and abiraterone acetate, docetaxel was the only established treatment with life-prolongation for CRPC. ENZ is a second-generation anti-androgen receptor drug that has contributed to improving the prognosis of CRPC. Several studies have reported factors predicting the efficacy of ENZ; however, there are no confirmed biomarkers. The neutrophil-to-lymphocyte ratio (NLR) is an easily calculated biomarker that is associated with the prognosis of several solid malignancies. However, there were few studies investigated NLR for ENZ in patients with mCRPC. We examined the usefulness of the NLR as a predictive tool for ENZ. Methods. We retrospectively examined a total of 106 CRPC patients who were treated with ENZ until September 2016 in Yokohama City University Hospital, Yokohama City University Medical Center, and National Cancer Center Hospital East. ENZ was routinely started as a dose of 160 mg per day; the dosage was reduced in some patients due to side effects. Drug holiday for 1-2 weeks or dose reduction to 80-120mg was done and no patients discontinued ENZ treatment due to adverse effects. ENZ was stopped when cancer progression was detected based on PSA elevation, radiographic findings, and deterioration of the patient’s performance status. The cut-off NLRs for overall survival (OS) and cancer-specific survival (CSS) were determined based on the receiver-operator curves. Kaplan-Meier curves were used to analyze the factors associated with OS or CSS and a log-rank test was performed. A multivariate analysis was also performed to analyze the factors associated with the prognosis. Results. We retrospectively reviewed 106 consecutive CRPC patients who were both treated with ENZ and were able to be counted before ENZ NLR. Cut-off point was 2.14 for both OS and CSS by receiver operator characteristic curve. The patients were then divided into the higher NLR group (≥2.14) and lower NLR group (<2.14). Multivariate analysis showed that NLR and predocetaxel chemotherapy were independent risk factors for both overall and cancer-specific survival. Conclusions. The NLR might be a useful biomarker for predicting the prognosis of mCRPC patients who are treated with ENZ.

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