Prognostic role of pan‐immune‐inflammation value in patients with metastatic castration‐resistant prostate cancer treated with androgen receptor‐signaling inhibitors

Abstract

Aim: To assess the prognostic effect of pan-immune inflammation value (PIV) in patients with metastatic castration-resistant prostate cancer (mCRPC) treated with abiraterone acetate (AA) or enzalutamide.Methods: Patients with mCRPC treated with AA or enzalutamide between January 2010 and June 2021 were included in this study. The most recently examined complete blood count values in the 1-month period before treatment were used for calculating PIV. The relationship between overall survival (OS) and PIV was evaluated by multivariate analysis. By using PIV and lactate dehydrogenase (LDH) levels which had shown survival effect at multivariate analysis, PIV−LDH combined score was established.Results: A total of 114 patients were included in this study. At the median follow-up of 34.6 months (95% confidence interval [CI]: 32.4-36.8), the median OS was 21 months (95% CI: 17.6−21.3). The median OS in the low-PIV group was significantly higher than in the high-PIV group (34.4 months (95% CI: 21.3-47.5) vs. 14.3 months (95% CI: 10.0-18.7), p < 0.001). In the multivariate analysis for OS, high PIV (hazard ratio [HR]: 1.86, 95% CI: 1.11−3.13, p = 0.018) and LDH value 1.5 times the upper limit of normal and above (HR: 3.65 95%, CI: 1.86−7.16, p < 0.001) were associated with shorter OS. When survival analysis was performed according to the PIV−LDH combined score, the median OS was 34.4 months (95% CI: 22.2-46.6) in the low-risk group, 17.7 months (95% CI: 11.7-23.6) in the intermediate-risk group, and 8.4 months (95% CI: 5.1-11.7) in the high-risk group (p < 0.001). The C-index of the combined PIV−LDH score was higher than the C-index of PIV (0.65 vs. 0.61). Conclusion:In this study, we demonstrated that PIV was an independent prognostic factor for OS in patients with mCRPC treated with AA or enzalutamide. Additionally, PIV−LDH combined score may be considered a promising composite peripheral blood-based biomarker to predict OS in those patients.

A Nomogram for Predicting Prostate Cancer with Lymph Node Involvement in Robot-Assisted Radical Prostatectomy Era: A Retrospective Multicenter Cohort Study in Japan (The MSUG94 Group)

“…Recently, biomarkers have been explored for various urologic cancers, including prostate cancer [ 28 , 29 , 30 , 31 , 32 , 33 , 34 ]. Liquid biopsy is an emerging biomarker for clinical decision making in PCa [ 35 ]. In patients with metastatic PCa, immunoinflammatory values were reported to be an independent prognostic factor for overall survival [ 36 ].…”

Radiotherapy-Related Gene Signature in Prostate Cancer

“…Moreover, as recently reviewed by Casanova-Salas et al, CTCs genetic profiling holds strong predictive potential for the identification of responders among prostate patients that receive androgen receptor signaling inhibitors (ARSI), PARP inhibitors and other therapeutic regimes [ 22 ]. Similarly, Yazgan et al found a pan-immune-inflammation value derived from total blood cell counts before treatment with ARSI with marked prognostic potential in patients with metastatic castration-resistant prostate cancer [ 24 ]. Regarding immunotherapy, PD-L1 is becoming quite popular as both genetic [ 25 ] and immunohistochemical [ 26 ] marker with prognostic and/or predictive roles in renal cancer patients treated with immune checkpoint inhibitors.…”

Emerging roles and potential application of PIWI-interacting RNA in urological tumors

“…In addition, piRNAs also have the potential to open the door to predict treatment response. Many prostate cancer patients treated with novel ARTAs, PARP inhibitors or immune checkpiont inhibitors ( 112 – 114 ). The above liquid biopsy can also be used to predict treatment response, but it is still not accurate enough.…”