To assess the baseline inflammatory markers modified Glasgow Prognostic Score (mGPS), systemic immune-inflammation index (SII), and neutrophile-to-lymphocyte ratio (NLR) as pragmatic tools for predicting response to chemohormonal therapy (docetaxel plus ADT) and prognosis in men with metastatic hormone-sensitive prostate cancer (mHSPC).
Male patients who received docetaxel at a tertiary university care center between 2014 and 2019 were screened for completion of 6 cycles. NLR, SII, mGPS, overall survival (OS), three-year survival, and radiologic response were assessed. Complete response (CR), partial response (PR), and stable disease (SD) were analyzed alone and in combination.
Thirty-six mHSPC-patients were included. In thirty patients, baseline mGPS was assessed and was either 0 (n=22) or 2 (n=8). In Cochran-Armitage Trend Test, mGPS showed significant association with the combined radiologic endpoint of "CR, PR, or SD" (p=0.01), three-year survival (p=0.02), and OS (p<0.01). Next to prostate-specific antigen (PSA) (HR per 100 units 1.16, 95%CI=1.04-1.30, p<0.01), NLR (HR=1.31, 95%CI=1.03-1.66, p=0.03), and mGPS (2 vs. 0, HR=6.53, 95%CI=1.6-27.0, p<0.01) at baseline showed significant association with OS in univariable cox regression. However, mGPS remained the only independent predictor for OS in multivariable cox regression (p<0.01) and for the combined radiologic endpoint of "CR, PR or SD" (p=0.01) in multivariable logistic regression. SII showed no statistical relevance.
Baseline mGPS seems to be a pragmatic tool for clinical decision-making in patients with mHSPC in daily routine.
Anticancer research. 2022 Apr [Epub]
Manuel Neuberger, Janina Skladny, Nora Goly, Frederik Wessels, Christel WEIß, Luisa Egen, Philipp Erben, Matthias GROß-Weege, Britta Grüne, Friedrich Hartung, Jonas Herrmann, Patrick Honeck, Jonas Jarczyk, Karl-Friedrich Kowalewski, Julia Mühlbauer, Katja Nitschke, Malin Nientiedt, Margarete Theresa Walach, Frank Waldbillig, Niklas Westhoff, Jost VON Hardenberg, Maximilian Kriegmair, Thomas S Worst, Philipp Nuhn
Department of Urology and Urologic Surgery, University Medical Center Mannheim (UMM), Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; ., Department of Urology and Urologic Surgery, University Medical Center Mannheim (UMM), Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany., Department of Medical Statistics and Biomathematics, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.