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.

Prognostic value of the pretreatment systemic immune-inflammation index in patients with prostate cancer: a systematic review and meta-analysis

“…Then, we excluded 13 studies because 2 studies were reviews, 2 studies were conference abstracts, 2 studies were in other languages, and 7 studies had no relevance to the topic. Finally, 12 studies with 8083 patients were eligible for quantitative synthesis [26,27,[32][33][34][35][36][37][38][39][40][41].…”

“…All of the included studies were retrospective and published between 2016 and 2022. Three studies were conducted in China [34,37,41], three in Italy [32,33,36], two in Germany [38,39], one in Japan [35], one in Austria [27], and two in multiple centers [26,40]. Regarding the tumor type, 8 studies focused on CRPC [27,[32][33][34][35][36][37][38][39], and the other 4 studies focused on other types of PCa [26,[39][40][41].…”

“…Three studies were conducted in China [34,37,41], three in Italy [32,33,36], two in Germany [38,39], one in Japan [35], one in Austria [27], and two in multiple centers [26,40]. Regarding the tumor type, 8 studies focused on CRPC [27,[32][33][34][35][36][37][38][39], and the other 4 studies focused on other types of PCa [26,[39][40][41]. The cutoff values of SII ranged from 160 to 1091 (median 580).…”

“…The cutoff values of SII ranged from 160 to 1091 (median 580). Ten studies reported the relationship between SII and OS [26,27,[32][33][34][35][36][37][38][39], six reported PFS [26,27,34,35,40,41], and only one reported CSS [26]. All of the included studies were considered high quality (no less than 7).…”

“…Ten studies including 1753 patients focused on the association between SII and OS in patients with PCa [26,27,[32][33][34][35][36][37][38][39]. The pooled HR showed that elevated preoperative SII was significantly associated with poor OS (HR = 1.44, 95% CI 1.23-1.69, p < 0.001).…”