Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA.
Departments of Biostatistics and Bioinformatics, Emory University, Atlanta, GA.
Urol Oncol. 2022 Jun;40(6):271.e9-271.e18. doi: 10.1016/j.urolonc.2022.03.016. Epub 2022 Apr 22.
Biomarkers have the potential to provide clinical guidance, but there is limited data for biomarkers in metastatic hormone sensitive prostate cancer (mHSPC).
We performed a retrospective multicenter review from Winship Cancer Institute at Emory University and Georgia Cancer Center for Excellence at Grady Memorial Hospital (2014-2020) in the United States of America (USA). We collected demographics, disease characteristics, and laboratory data, including complete blood counts (CBC) at the start of upfront therapy. We evaluated overall survival (OS) and progression-free survival (PFS) associated with baseline lab values.
165 patients were included with a median follow-up time of 33.5 months (mo). 105 (63.6%) had Gleason scores of 8-10 and 108 (65.9%) were classified as high-volume disease. 92 patients received upfront docetaxel (55.8%) and 73 received upfront abiraterone (44.2%). Univariate analyses (UVA) and multivariable analyses (MVA) identified worse clinical outcomes (CO) associated with elevated basophils and basophil-to-lymphocyte ratio (BLR). Based on MVA, elevated basophils (defined as ≥0.1, optimal cut) were associated with a hazard ratio (HR) of 3.51 (95% CI 1.65-7.43, P 0.001) for OS and HR of 1.88 (95% CI 1.05-3.38, P 0.034) for PFS. Our MVA also found that BLR ≥0.0142 was associated with HR 2.11 (95% CI 1.09-4.10, P 0.028) for OS; however, PFS was not statistically significant.
We conclude that elevated baseline basophils and BLR are associated with worse clinical outcomes in mHSPC. Although results require further validation, BLR is a potential prognostic biomarker.
生物标志物有可能提供临床指导,但转移性激素敏感前列腺癌(mHSPC)的生物标志物数据有限。
我们在美国佐治亚州埃默里大学的温希普癌症研究所和格鲁吉亚癌症卓越中心(2014-2020 年)进行了一项回顾性多中心研究。我们收集了人口统计学、疾病特征和实验室数据,包括初始治疗前的全血细胞计数(CBC)。我们评估了与基线实验室值相关的总生存期(OS)和无进展生存期(PFS)。
共纳入 165 例患者,中位随访时间为 33.5 个月(mo)。105 例(63.6%)患者的 Gleason 评分为 8-10 分,108 例(65.9%)为高容量疾病。92 例患者接受了初始多西他赛治疗(55.8%),73 例患者接受了初始阿比特龙治疗(44.2%)。单变量分析(UVA)和多变量分析(MVA)确定了与嗜碱性粒细胞和嗜碱性粒细胞与淋巴细胞比值(BLR)升高相关的不良临床结局(CO)。基于 MVA,升高的嗜碱性粒细胞(定义为≥0.1,最佳截断值)与 OS 的风险比(HR)为 3.51(95%CI 1.65-7.43,P 0.001),与 PFS 的 HR 为 1.88(95%CI 1.05-3.38,P 0.034)。我们的 MVA 还发现,BLR≥0.0142 与 OS 的 HR 为 2.11(95%CI 1.09-4.10,P 0.028)相关;然而,PFS 无统计学意义。
我们得出结论,基线嗜碱性粒细胞和 BLR 升高与 mHSPC 的不良临床结局相关。尽管结果需要进一步验证,但 BLR 是一种有潜力的预后生物标志物。