Neutrophil-to-Lymphocyte Ratio Predicts Prognosis in Castration-Resistant Prostate Cancer Patients Who Received Cabazitaxel Chemotherapy

Abstract

Introduction and Objectives An elevated neutrophil-to-lymphocyte ratio (NLR) has been suggested to be associated with a poor prognosis in several cancers. We evaluated the utility of an elevated NLR as a biomarker to predict the prognosis of metastatic castration-resistant prostate cancer (mCRPC) patients treated with cabazitaxel (CBZ). Methods We analyzed 47 patients who received CBZ chemotherapy for mCRPC in our institutions. The NLR was calculated using the neutrophil and lymphocyte counts before CBZ chemotherapy. We determined the NLR cut-off value based on the sensitivity and specificity levels derived from area under the receiver operator characteristic curves for death. A multivariate analysis was performed to investigate the association between the NLR and the prognosis. Results The median overall survival (OS) after CBZ was 10.0 months (range: 6.3–13.2). The median OS was shorter in patients with a high NLR (≥3.83) than in those with a low NLR (<3.83) (5.8 versus 13.2 months, p = 0.018). In the multivariate analysis, the NLR, patient age, and lymph node (LN) metastasis were independent predictors of the OS (hazard ratio 3.01, p = 0.030; hazard ratio 3.10, p = 0.029; hazard ratio 12.38, p = 0.001, resp.). Conclusions NLR might be a useful prognostic biomarker in mCRPC patients treated with CBZ.

Three-year follow-up of a phase II study of radium-223 dichloride in Japanese patients with symptomatic castration-resistant prostate cancer and bone metastases

“…These trends were generally consistent with previously reported prognostic factors in patients with mCRPC [ 22 – 26 ]. A trend for longer OS with lower neutrophil counts in the present study is likely to reflect the positive prognostic effect of lower NLR (neutrophil–lymphocyte ratio), which has been reported in several malignancies including prostate cancer [ 27 , 28 ]. The trend for longer OS with lower NLR may also be due to the increased immunity seen in patients lower NLR, which may in turn increase the efficacy of therapy by facilitating an abscopal effect, where a response is observed in lesions that are distant from the site of treatment.…”

Neutrophil&ndash;lymphocyte ratio is a predictor of prognosis in patients with castration-resistant prostate cancer: a meta-analysis

“…The 16 selected studies (17 cohorts) published between 2013 and 2017 were included in the meta-analysis. 21 – 24 , 28 – 39 The sample size ranged from 33 to 1,224 patients, and a total of 5,705 patients were included. All trials were conducted in adult patients with CRPC.…”

“… 15 – 18 NLR has shown to predict poor survival of patient with localized prostate cancer and CRPC. 19 – 24 However, the results of these studies for the prognostic value of NLR are inconsistent. We conducted a comprehensive meta-analysis to drive a more precise estimate of the prognostic value of the NLR in patients with CRPC.…”

Chronic kidney disease and positive surgical margins as prognosticators for upper urinary tract urothelial carcinoma patients undergoing radical nephroureterectomy

“…We performed univariate and multivariate analyses by using the Cox proportional hazards model to identify independent factors for shorter disease-specific and recurrence-free survival time. We also performed a receiver operator characteristic(ROC) analysis to determine the cut-off values of eGFR, CAR, NLR, PLR, and fibrinogen levels according to the method shown in previous reports (19)(20)(21)(22). We constructed the survival curves by using the Kaplan-Meier method and evaluated the statistical differences among them with the log-rank test.…”