Neutropenia, neutrophilia, and neutrophil-lymphocyte ratio as prognostic markers in patients with metastatic castration-resistant prostate cancer
© The Author(s), 2022..
Background and purpose: Chemotherapy-induced neutropenia and neutrophil-to-lymphocyte ratio (NLR) are potentially useful prognostic markers in patients with metastatic castration-resistant prostate cancer (mCRPC). This post hoc analysis investigated whether these markers can be utilized for dose considerations and evaluated the prognostic impact of leukocyte subtypes.
Patients and methods: PROSELICA assessed the non-inferiority of cabazitaxel 20 mg/m2 (C20; n = 598) versus 25 mg/m2 (C25; n = 602) for overall survival (OS) in patients with mCRPC previously treated with docetaxel. The association of grade ⩾ 3 neutropenia, NLR, baseline neutrophilia and lymphopenia with OS, progression-free survival (PFS), and prostate-specific antigen response rate (PSArr) was investigated by an unplanned uni- and multivariate analyses.
Results: PROSELICA confirmed the negative prognostic value of increased baseline NLR [⩾3, hazard ratio (HR) 1.40; p < 0.0001], but did not identify a subgroup of patients benefiting more from C20 or C25. In this post hoc analysis, patients who developed grade ⩾3 neutropenia (n = 673) had a significantly improved OS [∆OS = 2.7 months, HR = 0.78 (95% CI 0.68-0.89)] with the greatest advantage observed in patients with baseline neutrophilia [n = 85; 5.3 months, 0.60 (0.42-0.84)]. After adjustment for the Halabi criteria, neutropenia grade ⩾ 3 was the only biomarker that remained significantly associated with OS [ (HR 0.86 (0.75-0.98)], PFS [HR 0.78 (0.68-0.88)], and PSArr [odds ratio (OR) 1.82 (1.37-2.41)] while neutrophilia showed the strongest association with OS [1.53 (1.29-1.81)].
Conclusions: Grade ⩾ 3 neutropenia was the only leukocyte-based biomarker associated with all key outcome parameters in mCRPC patients receiving cabazitaxel and might be able to overcome the negative prognostic effect of baseline neutrophilia.
NCT number: NCT01308580.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:14 |
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| Enthalten in: |
Therapeutic advances in medical oncology - 14(2022) vom: 30., Seite 17588359221100022 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Meisel, Alexander [VerfasserIn] |
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| Links: |
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| Themen: |
Cabazitaxel |
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| Anmerkungen: |
Date Revised 22.03.2023 published: Electronic-eCollection ClinicalTrials.gov: NCT01308580 Citation Status PubMed-not-MEDLINE |
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| doi: |
10.1177/17588359221100022 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM341990833 |
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| 100 | 1 | |a Meisel, Alexander |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Neutropenia, neutrophilia, and neutrophil-lymphocyte ratio as prognostic markers in patients with metastatic castration-resistant prostate cancer |
| 264 | 1 | |c 2022 | |
| 336 | |a Text |b txt |2 rdacontent | ||
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| 500 | |a Date Revised 22.03.2023 | ||
| 500 | |a published: Electronic-eCollection | ||
| 500 | |a ClinicalTrials.gov: NCT01308580 | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a © The Author(s), 2022. | ||
| 520 | |a Background and purpose: Chemotherapy-induced neutropenia and neutrophil-to-lymphocyte ratio (NLR) are potentially useful prognostic markers in patients with metastatic castration-resistant prostate cancer (mCRPC). This post hoc analysis investigated whether these markers can be utilized for dose considerations and evaluated the prognostic impact of leukocyte subtypes | ||
| 520 | |a Patients and methods: PROSELICA assessed the non-inferiority of cabazitaxel 20 mg/m2 (C20; n = 598) versus 25 mg/m2 (C25; n = 602) for overall survival (OS) in patients with mCRPC previously treated with docetaxel. The association of grade ⩾ 3 neutropenia, NLR, baseline neutrophilia and lymphopenia with OS, progression-free survival (PFS), and prostate-specific antigen response rate (PSArr) was investigated by an unplanned uni- and multivariate analyses | ||
| 520 | |a Results: PROSELICA confirmed the negative prognostic value of increased baseline NLR [⩾3, hazard ratio (HR) 1.40; p < 0.0001], but did not identify a subgroup of patients benefiting more from C20 or C25. In this post hoc analysis, patients who developed grade ⩾3 neutropenia (n = 673) had a significantly improved OS [∆OS = 2.7 months, HR = 0.78 (95% CI 0.68-0.89)] with the greatest advantage observed in patients with baseline neutrophilia [n = 85; 5.3 months, 0.60 (0.42-0.84)]. After adjustment for the Halabi criteria, neutropenia grade ⩾ 3 was the only biomarker that remained significantly associated with OS [ (HR 0.86 (0.75-0.98)], PFS [HR 0.78 (0.68-0.88)], and PSArr [odds ratio (OR) 1.82 (1.37-2.41)] while neutrophilia showed the strongest association with OS [1.53 (1.29-1.81)] | ||
| 520 | |a Conclusions: Grade ⩾ 3 neutropenia was the only leukocyte-based biomarker associated with all key outcome parameters in mCRPC patients receiving cabazitaxel and might be able to overcome the negative prognostic effect of baseline neutrophilia | ||
| 520 | |a NCT number: NCT01308580 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a cabazitaxel | |
| 650 | 4 | |a mCRPC | |
| 650 | 4 | |a neutropenia | |
| 650 | 4 | |a neutrophil-to-lymphocyte ratio | |
| 650 | 4 | |a neutrophilia | |
| 650 | 4 | |a prostate cancer | |
| 700 | 1 | |a de Wit, Ronald |e verfasserin |4 aut | |
| 700 | 1 | |a Oudard, Stephane |e verfasserin |4 aut | |
| 700 | 1 | |a Sartor, Oliver |e verfasserin |4 aut | |
| 700 | 1 | |a Stenner-Liewen, Frank |e verfasserin |4 aut | |
| 700 | 1 | |a Shun, Zhenming |e verfasserin |4 aut | |
| 700 | 1 | |a Foster, Meredith |e verfasserin |4 aut | |
| 700 | 1 | |a Ozatilgan, Ayse |e verfasserin |4 aut | |
| 700 | 1 | |a Eisenberger, Mario |e verfasserin |4 aut | |
| 700 | 1 | |a de Bono, Johann S |e verfasserin |4 aut | |
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