Systemic inflammatory biomarkers as predictive and prognostic factors in men with metastatic castration-refractory prostate cancer treated with docetaxel therapy: a comprehensive analysis in a German real-world cohort.

Abstract

PURPOSE:

Advances in therapy of metastatic castration-refractory prostate cancer (mCRPC) resulted in more therapeutic options and led to a higher need of predictive/prognostic biomarkers. Systemic inflammatory biomarkers could provide the basis for personalized treatment selection. This study aimed to assess the modified Glasgow Prognostic Score (mGPS), the neutrophile-to-lymphocyte ratio (NLR), the platelet-to-lymphocyte ratio (PLR) and the systemic immune-inflammation index (SII) in men with mCRPC under docetaxel.

METHODS:

Patients with mCRPC and taxane chemotherapy at a tertiary care centre between 2010 and 2019 were screened retrospectively. The biomarkers mGPS, NLR, PLR and SII were assessed and analyzed for biochemical/radiologic response and survival.

RESULTS:

We included 118 patients. Of these, 73 (61.9%) had received docetaxel as first-line, 31 (26.2%) as second-line and 14 (11.9%) as third-line treatment. For biochemical response, mGPS (odds ratio (OR) 0.54, p = 0.04) and PLR (OR 0.63, p = 0.04) were independent predictors in multivariable analysis. SII was significant in first-line cohort only (OR 0.29, p = 0.02). No inflammatory marker was predictive for radiologic response. In multivariable analysis, mGPS and NLR (hazard ratio (HR) 1.71 and 1.12, both p < 0.01) showed significant association with OS in total cohort and mGPS in the first-line cohort (HR 2.23, p < 0.01). Haemoglobin (Hb) and alkaline phosphatase (AP) showed several significant associations regarding 1 year, 3 year, OS and biochemical/radiologic response.

CONCLUSIONS:

Pre-treatment mGPS seems a promising prognostic biomarker. A combination of mGPS, NLR and further routine markers (e.g., Hb and AP) could yield optimized stratification for treatment selection. Further prospective and multicentric assessment is needed.

• Authors: Manuel Neuberger, Nora Goly, Janina Skladny, Veronica Milczynski, Christel Weiß, Frederik Wessels, Katja Nitschke, Britta Grüne, Caelán M Haney, Friedrich Hartung, Jonas Herrmann, Jonas Jarczyk, Karl F Kowalewski, Frank Waldbillig, Maximilian C Kriegmair, Niklas Westhoff, Thomas S Worst, Philipp Nuhn
• Journal: Journal of cancer research and clinical oncology (J Cancer Res Clin Oncol) Vol. 149 Issue 7 Pg. 3371-3381 (Jul 2023) ISSN: 1432-1335 [Electronic] Germany
• PMID: 35939112 (Publication Type: Journal Article)
• Copyright: © 2022. The Author(s).

Chemical References

• Docetaxel
• Biomarkers

Topics

• Male
• Humans
• Docetaxel
• Prognosis
• Prostatic Neoplasms, Castration-Resistant (drug therapy, pathology)
• Retrospective Studies
• Biomarkers
• Lymphocytes (pathology)
• Neutrophils (pathology)
• Inflammation (pathology)
• Castration