title: The Role of the Neutrophil to Lymphocyte Ratio for Survival Outcomes in Patients with Metastatic Castration-Resistant Prostate Cancer Treated with Abiraterone.
abstract: The purpose of this study was to examine the prognostic capability of baseline neutrophil-to-lymphocyte-ratio (NLR) and NLR-change under Abiraterone in metastatic castration-resistant prostate cancer patients. The impact of baseline NLR and change after eight weeks of treatment on progression-free survival (PFS) and overall survival (OS) was analyzed using Kaplan-Meier-estimates and Cox-regression. 79 men with baseline NLR <5 and 17 with NLR >5 were analyzed. In baseline analysis of PFS NLR >5 was associated with non-significantly shorter median PFS (five versus 10 months) (HR: 1.6 (95%CI:0.9-2.8);p= 0.11). After multivariate adjustment (MVA), ECOG > 0-1, baseline LDH>upper limit of normal (UNL) and presence of visceral metastases were independent prognosticators. For OS, NLR >5 was associated with shorter survival (seven versus 19 months) (HR: 2.3 (95%CI:1.3-4.0);p< 0.01). In MVA, ECOG > 0-1 and baseline LDH > UNL remained independent prognosticators. After 8 weeks of Abiraterone NLR-change to <5 prognosticated worse PFS (five versus 12 months) (HR: 4.1 (95%CI:1.1-15.8);p= 0.04). MVA showed a trend towards worse PFS for NLR-change to <5 (p= 0.11). NLR-change to <5 led to non-significant shorter median OS (seven versus 16 months) (HR: 2.3 (95%CI:0.7-7.1);p= 0.15). MVA showed non-significant difference for OS. We concluded baseline NLR <5 is associated with improved survival. In contrast, in patients with baseline NLR >5, NLR-change to <5 after eight weeks of Abiraterone was associated with worse survival and should be interpreted carefully.
authors.affiliation: Department of Urology, Prostate Center, University Hospital Muenster, Albert-Schweitzer-Campus 1, GB A1, D-48149 Muenster, Germany. martin.boegemann@ukmuenster.de.
authors.forename: Martin
authors.initials: M
authors.lastname: Boegemann
authors.affiliation: Department of Urology, Prostate Center, University Hospital Muenster, Albert-Schweitzer-Campus 1, GB A1, D-48149 Muenster, Germany. katrin.schlack@ukmuenster.de.
authors.forename: Katrin
authors.initials: K
authors.lastname: Schlack
authors.affiliation: Department of Urology, Prostate Center, University Hospital Muenster, Albert-Schweitzer-Campus 1, GB A1, D-48149 Muenster, Germany. s_thom09@uni-muenster.de.
authors.forename: Stefan
authors.initials: S
authors.lastname: Thomes
authors.affiliation: Department of Urology, Prostate Center, University Hospital Muenster, Albert-Schweitzer-Campus 1, GB A1, D-48149 Muenster, Germany. Julie.steinestel@ukmuenster.de.
authors.forename: Julie
authors.initials: J
authors.lastname: Steinestel
authors.affiliation: Department of Nuclear Medicine, Muenster University Medical Center, Albert-Schweitzer-Campus 1, GB A1, D-48149 Muenster, Germany. kambiz.rahbar@ukmuenster.de.
authors.forename: Kambiz
authors.initials: K
authors.lastname: Rahbar
authors.affiliation: Department of Urology, Prostate Center, University Hospital Muenster, Albert-Schweitzer-Campus 1, GB A1, D-48149 Muenster, Germany. axel.semjonow@ukmuenster.de.
authors.forename: Axel
authors.initials: A
authors.lastname: Semjonow
authors.affiliation: Department of Urology, Prostate Center, University Hospital Muenster, Albert-Schweitzer-Campus 1, GB A1, D-48149 Muenster, Germany. andresjan.schrader@ukmuenster.de.
authors.forename: Andres Jan
authors.initials: AJ
authors.lastname: Schrader
authors.affiliation: Department of Rheumatology, Dresden University Medical Center, Fetscherstraße 74, D-01307 Dresden, Germany. martin.aringer@uniklinikum-dresden.de.
authors.forename: Martin
authors.initials: M
authors.lastname: Aringer
authors.affiliation: Department of Urology, Prostate Center, University Hospital Muenster, Albert-Schweitzer-Campus 1, GB A1, D-48149 Muenster, Germany. laura-maria.krabbe@ukmuenster.de.|Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX 75390-9110, USA. laura-maria.krabbe@ukmuenster.de.
authors.forename: Laura-Maria
authors.initials: LM
authors.lastname: Krabbe
mesh_terms: D000368:Aged; D000736:Androstenes / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D006801:Humans; D053208:Kaplan-Meier Estimate; D007958:Leukocyte Count; D008214:Lymphocytes; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009504:Neutrophils; D011379:Prognosis; D016016:Proportional Hazards Models; D064129:Prostatic Neoplasms, Castration-Resistant / Q000097:blood* / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D000736:Androstenes; D000970:Antineoplastic Agents; C089740:abiraterone
keywords: abiraterone; castration-resistant prostate cancer; neutrophil-to-lymphocyte ratio; prognostic biomarker; treatment response