Predictive and prognostic value of preoperative complete blood count in prostate cancer

177Lutetium PSMA-617 (Lu-PSMA) therapy in patients with metastatic castration resistant prostate cancer (mCRPC) has gained visibility through the ongoing phase III trial. The data on prediction of therapy outcome and survival out of pretherapeutic imaging parameters is still sparse. In this study, the predictive and prognostic value of radiomic features from 68Ga-PSMA-11 PET-MRI are analyzed. In total, 21 patients with mCRPC underwent 68Ga-PSMA-11 PET-MRI before Lu-PSMA therapy. The PET-positive tumor volume was defined and transferred to whole-body T2-, T1- and contrast-enhanced T1-weighted MRI-sequences. The radiomic features from PET and MRI sequences were extracted by using a freely available software package. For selecting features that allow differentiation of biochemical response (PSA decrease > 50%), a stepwise dimension reduction was performed. Logistic regression models were fitted, and selected features were tested for their prognostic value (overall survival) in all patients. Eight patients achieved biochemical response after Lu-PSMA therapy. Ten independent radiomic features differentiated well between responders and non-responders. The logistic regression model, including the feature interquartile range from T2-weighted images, revealed the highest accuracy (AUC = 0.83) for the prediction of biochemical response after Lu-PSMA therapy. Within the final model, patients with a biochemical response (p = 0.003) and higher T2 interquartile range values in pre-therapeutic imaging (p = 0.038) survived significantly longer. This proof-of-concept study provides first evidence on a potential predictive and prognostic value of radiomic analysis of pretherapeutic 68Ga-PSMA-11 PET-MRI before Lu-PSMA therapy.

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Association of neutrophil count with overall survival in localized prostate cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2015.33.7_suppl.121 ◽

2015 ◽

Vol 33 (7_suppl) ◽

pp. 121-121

Author(s):

Daniel Taussky ◽

Houda Bahig ◽

Guila Delouya ◽

Paule Bodson-Clermont ◽

Denis Soulieres

Keyword(s):

Prostate Cancer ◽

Overall Survival ◽

Neutrophil Count ◽

Biochemical Recurrence ◽

Blood Count ◽

Complete Blood Count ◽

Univariate Analysis ◽

Multivariate Model ◽

Localized Prostate Cancer ◽

Overall Mortality

121 Background: Systemic inflammation has been linked to worse outcome in metastatic prostate cancer. This study analyzes the influence of complete blood count (CBC) on outcome after curative radiotherapy for localized prostate cancer. Methods: We reviewed our institutional database of patients with localized prostate cancer treated with either definitive external beam radiotherapy (EBRT) or brachytherapy from September 2001- June 2014. Data on pre-treatment CBC such as hemoglobin (Hgb), mean corpuscular volume(MCV) and platelet count (PLT) were available in 1,021 pts, neutrophil/lymphocyte ratio (NLR) in 1,015 pts. Univariate and multivariate cox proportional hazards models were used to analyze the influence of complete blood count parameters on overall and recurrence free survival (PSA nadir + 2 ng/mL). A p<0.05 was considered statistically significant. Results: Median follow-up was 44 months. 55 patients had biochemical recurrence and 68 patients died.On univariate analysis, increasing risk of biochemical recurrence was associated with a combination of all known risk factors as defined by the Cancer of the Prostate Risk Assessment (CAPRA) score, but not by age. When adjusting for age (p=0.009), CAPRA remained significant (p=0.0003) but no comorbidity or CBC. On univariate analysis for overall survival, CAPRA (p=0.0001) and neutrophil count (p=0.04, HR1.16, 1.01-1.34) as well as a cardiac history (p=0.009) were associated with increased risk of overall mortality. The first multivariate model was adjusted for age and included the CAPRA, comorbidity and CBC variables: age (p=0.006) and CAPRA (p=0.008) were prognostic, neutrophil count was borderline significant (p=0.056, HR 1.17, 0.99-1.37). In a second multivariate model without adjusting for age, neutrophil count was a significant prognostic factor for overall survival (p=0.032, HR 1.18, 1.01-1.38) as well as the CAPRA (p=0.005, HR 1.18, 1.05-1.33). Conclusions: In this testing cohort, neutrophil count was an independent risk factor for increased overall mortality in patients with localized prostate cancer. The influence of age on this prognostic factor will be further studied. A validation cohort is needed to corroborate these results.

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A combination of both testosterone and white blood count as predictive factors of overall survival in localized prostate cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.6_suppl.129 ◽

2017 ◽

Vol 35 (6_suppl) ◽

pp. 129-129

Author(s):

Daniel Taussky ◽

Denis Soulieres ◽

Laurent Azoulay ◽

Hui Yin ◽

Houda Bahig ◽

...

Keyword(s):

Prostate Cancer ◽

Overall Survival ◽

Biochemical Recurrence ◽

Blood Count ◽

Complete Blood Count ◽

Large Population ◽

Cox Proportional Hazards ◽

Localized Prostate Cancer ◽

White Blood Count ◽

Increased Risk

129 Background: Low testosterone is generally associated with a higher overall mortality rate. We previously published that an increase in neutrophils is associated with lower overall survival in a large population of patients with localized prostate cancer. In this study, we tested a combination of both testosterone and neutrophils to predict for overall survival in a prospective cohort of patients treated with radiotherapy for localized prostate cancer. Methods: 414 patients from our institutional database were enrolled prospectively in phase 2 or 3 studies. To be included in this present analysis, patients had to have a baseline testosterone and complete blood count before enrollment in their respective study. Thirty-three patients were excluded for missing data for a total of 381 (92%) patients were included for analysis. Multivariate cox proportional hazards models were used to analyze the influence of white blood count (WBC = neutrophils + lymphocytes) and testosterone level on biochemical recurrence (Phoenix definition) and overall survival (OS). A cutoff level for testosterone of 10.4 nmol/l ( = 300ng/dL) was used as an indicator of hypogonadism and a WBC cutoff of 6.2 (109/L) representing the median value of this study population. Results were adjusted for cancer characteristics, comorbidities and androgen deprivation therapy. Results: Median age (range) was 71 (52-82) years. The median follow-up for biochemical recurrence and OS analysis were 72 and 78 months, respectively. WBC and testosterone were not predictive of biochemical recurrence, but CAPRA score 6-10 vs. ≤ 2 was (HR 5.39, 95% CI 1.19-24.45). WBC ≥ 6.2 alone was not associated with OS (HR 0.66, 95% CI 0.30-1.46), but when combined with a testosterone > 10.3 nmol/l, it was associated with a HR of 2.96 (95%CI 1.45-6.06) when compared to a WBC < 6.2, P-interaction = 0.01. Conclusions: A combination of high WBC and normal testosterone levels seem to be associated with increased mortality in patients with localized prostate cancer. Validation in larger samples is needed and could help to identify patients with increased risk of mortality within the first 6-7 years post treatment.

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