MP29-10 PROGNOSTIC VALUE OF NEUTROPHIL-TO-LYMPHOCYTE RATIO (NLR) IN PATIENTS WITH METASTATIC CASTRATION-RESISTANT PROSTATE CANCER (MCRPC) RECEIVING PROSTATE-SPECIFIC MEMBRANE ANTIGEN (PSMA) TARGETED RADIONUCLIDE THERAPY (TRT)

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP29-10 PROGNOSTIC VALUE OF NEUTROPHIL-TO-LYMPHOCYTE RATIO (NLR) IN PATIENTS WITH METASTATIC CASTRATION-RESISTANT PROSTATE CANCER (MCRPC) RECEIVING PROSTATE-SPECIFIC MEMBRANE ANTIGEN (PSMA) TARGETED RADIONUCLIDE THERAPY (TRT) Judith Stangl-Kremser, Michael Sun, Benedict Ho, Joseph Thomas, Jones Nauseef, Joseph Osborne, Ana Molina, Cora Sternberg, David Nanus, Neil Bander, and Scott Tagawa Judith Stangl-KremserJudith Stangl-Kremser More articles by this author , Michael SunMichael Sun More articles by this author , Benedict HoBenedict Ho More articles by this author , Joseph ThomasJoseph Thomas More articles by this author , Jones NauseefJones Nauseef More articles by this author , Joseph OsborneJoseph Osborne More articles by this author , Ana MolinaAna Molina More articles by this author , Cora SternbergCora Sternberg More articles by this author , David NanusDavid Nanus More articles by this author , Neil BanderNeil Bander More articles by this author , and Scott TagawaScott Tagawa More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003257.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: PSMA TRT is a promising therapy for patients with mCRPC. Known prognostic factors for mCRPC include CALGB (Halabi) risk group and baseline circulating tumor cell (CTC) count. Here, we report associations between NLR and PSA response and overall survival (OS) in men with mCRPC treated on sequential prospective clinical trials at a single institution. METHODS: Patients treated on prospective studies from 2000 to 2021 were included in this analysis. Variables assessed: baseline neutrophil count:lymphocyte count ratio, baseline CTC count (CellSearch, favorable vs unfavorable), CALGB risk group, and administered radioactivity level. We used a Cox proportional hazards model to investigate the association between NLR and OS and logistic regression to determine the association between NLR and >50% PSA decline (PSA50). RESULTS: 180 patients were included in this analysis. Median age 71 (IQR 66-77.5), PSA 57.3 ng/mL (21.3-294.9), 80 (44.4%) prior chemotherapy, 86 (47.7%) prior abiraterone or androgen receptor signaling inhibitor, 167 (92.8%) bone metastases, 141 (78.3%) nodal metastases, 113 (62.8%) CALGB high-risk group. 94 (52.2%) received 177Lu-J591, 51 (28.3%) 177Lu-PSMA-617, 28 (15.6%) 225Ac-J591, 7 (3.9%) 90Y-J591. Median ANC 4.1 (IQR 3.1-5.1), ALC 1 (0.75-1.5), NLR 3.75 (2.63-5.92). On univariate analysis, higher NLR was associated with worse OS (HR 1.06, 95%CI 1.02-1.09, p=0.002) and trended toward lower rates of PSA50 (HR 1.08; 95% CI 0.99-1.17, p=0.067). On multivariable analysis, after controlling for CTC count and CALGB risk group, the relationship between higher NLR and worse OS persisted (HR 1.05; 95% CI 1.003-1.11, p=0.036). Stratifying patients by low vs high NLR (relative to median NLR), patients with low NLR had longer OS (23.7 vs 15 months, p=0.024). CONCLUSIONS: For patients with mCRPC receiving PSMA TRT, NLR may have prognostic implications with higher NLR associating with lower likelihood of PSA response and shorter overall survival. Source of Funding: NIH, Department of Defense, Weill Cornell Medicine, Prostate Cancer Foundation © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e384 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Judith Stangl-Kremser More articles by this author Michael Sun More articles by this author Benedict Ho More articles by this author Joseph Thomas More articles by this author Jones Nauseef More articles by this author Joseph Osborne More articles by this author Ana Molina More articles by this author Cora Sternberg More articles by this author David Nanus More articles by this author Neil Bander More articles by this author Scott Tagawa More articles by this author Expand All Advertisement PDF downloadLoading ...