Department of Urology, Weill Cornell Medicine, New York, New York, USA.
Department of Medicine, Division of Hematology and Medical Oncology, Weill Cornell Medicine, New York, New York, USA.
Prostate. 2023 Oct;83(14):1351-1357. doi: 10.1002/pros.24597. Epub 2023 Jul 9.
Neutrophil count:lymphocyte count ratio (NLR) may be a prognostic factor for men with advanced prostate cancer. We hypothesized that it is associated with prostate-specific antigen (PSA) response and survival in men treated with prostate-specific membrane antigen (PSMA)-targeted radionuclide therapy (TRT).
Data of 180 men with metastatic castration-resistant prostate cancer (mCRPC) who were treated in sequential prospective radionuclide clinical trials from 2002 to 2021 (utilizing 177Lu-J591, 90Y-J591, 177Lu-PSMA-617, or 225Ac-J591) were retrospectively analyzed. We used a logistic regression to determine the association between NLR and ≥50% PSA decline (PSA50) and a Cox proportional hazards model to investigate the association between NLR and overall survival (OS).
A total of 94 subjects (52.2%) received 177Lu-J591, 51 (28.3%) 177Lu-PSMA-617, 28 (15.6%) 225Ac-J591, and 7 (3.9%) 90Y-J591. The median NLR of 3.75 was used as cut-off (low vs. high NLR; n = 90, respectively). On univariate analysis, NLR was not associated with PSA50 (HR 1.08; 95% confidence interval [CI] 0.99-1.17, p = 0.067). However, it was associated with worse OS (hazard ratio [HR] 1.06, 95% CI 1.02-1.09, p = 0.002), also after controlling for circulating tumor cell count and cancer and leukemia group B risk group (HR 1.05; 95% CI 1.003-1.11, p = 0.036). Men with high NLR were at a higher hazard of death from all causes (HR 1.43, 95% CI 1.05-1.94, p = 0.024).
NLR provides prognostic information in the setting of patients with mCRPC receiving treatment with PSMA-TRT.
中性粒细胞与淋巴细胞比值（NLR）可能是晚期前列腺癌男性的预后因素。我们假设它与前列腺特异性膜抗原（PSMA）靶向放射性核素治疗（TRT）治疗的男性的前列腺特异性抗原（PSA）反应和生存相关。
我们回顾性分析了 2002 年至 2021 年连续前瞻性放射性核素临床试验中 180 例转移性去势抵抗性前列腺癌（mCRPC）男性的数据（使用 177Lu-J591、90Y-J591、177Lu-PSMA-617 或 225Ac-J591）。我们使用逻辑回归来确定 NLR 与 PSA50 下降≥50%（PSA50）之间的关系，并使用 Cox 比例风险模型来研究 NLR 与总生存（OS）之间的关系。
共有 94 名患者（52.2%）接受了 177Lu-J591、51 名患者（28.3%）接受了 177Lu-PSMA-617、28 名患者（15.6%）接受了 225Ac-J591 和 7 名患者（3.9%）接受了 90Y-J591。中位数为 3.75 的 NLR 用作截断值（低 NLR 与高 NLR；分别为 n=90）。单因素分析显示，NLR 与 PSA50 无相关性（HR 1.08；95%CI 0.99-1.17，p=0.067）。然而，它与较差的 OS 相关（HR 1.06，95%CI 1.02-1.09，p=0.002），即使在控制循环肿瘤细胞计数和癌症和白血病组 B 风险组后也是如此（HR 1.05；95%CI 1.003-1.11，p=0.036）。NLR 较高的男性死于任何原因的风险更高（HR 1.43，95%CI 1.05-1.94，p=0.024）。
NLR 为接受 PSMA-TRT 治疗的 mCRPC 患者提供了预后信息。
