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. 2023 Jul;149(7):3371-3381.
doi: 10.1007/s00432-022-04220-w. Epub 2022 Aug 8.

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

Manuel Neuberger  1 , Nora Goly  2 , Janina Skladny  2 , Veronica Milczynski  2 , Christel Weiß  3 , Frederik Wessels  2 , Katja Nitschke  2 , Britta Grüne  2 , Caelán M Haney  4 , Friedrich Hartung  2 , Jonas Herrmann  2 , Jonas Jarczyk  2 , Karl F Kowalewski  2 , Frank Waldbillig  2 , Maximilian C Kriegmair  2 , Niklas Westhoff  2 , Thomas S Worst  2 , Philipp Nuhn  2
Affiliations

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

Manuel Neuberger et al. J Cancer Res Clin Oncol. 2023 Jul.

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.

Keywords: Biomarker; Metastatic castration-refractory prostate cancer; Pre-treatment; Prognosis; Systemic inflammatory markers.

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Conflict of interest statement

The authors have no relevant financial or non-financial interests to disclose.

Figures

Fig. 1
Fig. 1
Flow-diagram and docetaxel treatment information of study cohort
Fig. 2
Fig. 2
Kaplan–Meier analysis of overall survival (OS) [months] depending on A mGPS in the total cohort B mGPS in the docetaxel first-line subgroup C NLR in the total cohort and D NLR in the docetaxel first-line subgroup
See this image and copyright information in PMC

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