Prognostic role of platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio in patients with metastatic castration resistant prostate cancer treated with abiraterone or enzalutamide.

BACKGROUND

Platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) are markers of systemic inflammation associated with poor outcome in several solid tumors. We retrospectively investigated the prognostic role of PLR and, secondly, NLR in mCRPC patients treated with abiraterone acetate (AA) or Enzalutamide (E), both in pre- and postdocetaxel setting.

METHODS

Two hundred twenty-five mCRPC patients treated with AA or E with basal blood count were divided in three groups according to PLR (PLR1<128; PLR2 128-190; PLR>190) and in two groups according to NLR (<3 vs. ≥3). Outcome measures were progression-free survival (PFS) and overall-survival (OS). Univariate and multivariate analyses were performed.

RESULTS

One hundred ten patients were in PLR1, 58 in PLR2 and 57 in PLR3. Median OS was 22.0, 20.6 and 21.2 months in PLR1, PLR2 and PLR3 (PLR2 vs. PLR1: HR 0.97, 95%CI 0.62-1.52, P=0.90; PLR3 vs. PLR1: HR 1.37, 95%CI 0.90-2.08, P=0.14). Median PFS was 9.2, 12.7 and 8.5 months in PLR1, PLR2 and PLR3 (PLR2 vs. PLR1: HR 0.87, 95%CI 0.59-1.27, P=0.47; PLR3 vs. PLR1: HR 1.15, 95%CI 0.80-1.66, P=0.45). 142 patients were in NLR<3 and 83 in NLR≥3. Median OS was 26.5 months in NLR<3 and 17.0 months in NLR≥3 (HR 1.75, 95%CI 1.22-2.51, P=0.02). Median PFS was 10.1 months in NLR<3 and 7.6 months in NLR≥3 (HR 1.37, 95%CI 1.00-1.88, P=0.05).

CONCLUSIONS

In this retrospective analysis of mCRPC patients treated with AA or E we did not identify a prognostic role of baseline PLR, while we found a significant prognostic role of baseline NLR.