Systemic immune-inflammation index predicts the clinical outcome in patients with mCRPC treated with abiraterone

Cristian Lolli, Orazio Caffo, Emanuela Scarpi, Michele Aieta, Vincenza Conteduca, Francesca Maines, Emanuela Bianchi, Francesco Massari, Antonello Veccia, Vincenzo E. Chiuri, Gaetano Facchini, Ugo De Giorgi

Research output: Contribution to journalArticle

Abstract

Background: A systemic immune-inflammation index (SII) based on neutrophil (N), lymphocyte (L), and platelet (P) counts has shown a prognostic impact in several solid tumors. The aim of this study is to evaluate the prognostic role of SII in metastatic castration-resistant prostate cancer (mCRPC) patients treated with abiraterone post docetaxel. Patients and Methods: We retrospectively reviewed consecutive mCRPC patients treated with abiraterone after docetaxel in our Institutions. X-tile 3.6.1 software, cut-offvalues of SII, neutrophil-to-lymphocyte ratio (NLR) defined as N/L and platelets-to-lymphocyte ratio (PLR) as P/L. Overall survival (OS) and their 95% Confidence Intervals (95% CI) was estimated by the Kaplan-Meier method and compared with the log-rank test. The impact of SII, PLR, and NLR on overall survival (OS) was evaluated by Cox regression analyses and on prostate-specific antigen (PSA) response rates were evaluated by binary logistic regression. Results: A total of 230 mCRPC patients treated abiraterone were included. SII ≥ 535, NLR ≥ 3 and PLR ≥ 210 were considered as elevated levels (high risk groups. The median OS was 17.3 months, 21.8 months in SII < 535 group and 14.7 months in SII ≥ 535 (p < 0.0001). At univariate analysis Eastern Cooperative Oncology Group (ECOG) performance status, previous enzalutamide, visceral metastases, SII, NLR, and PLR predicted OS. In multivariate analysis, ECOG performance status, previous enzalutamide, visceral metastases, SII, and NLR remained significant predictors of OS [hazard ratio (HR) = 5.08, p < 0.0001; HR = 2.12, p = 0.009, HR = 1.77, 95% p = 0.012; HR = 1.80, p = 0.002; and HR = 1.90, p = 0.001, respectively], whereas, PLR showed a borderline ability only (HR = 1.41, p = 0.068). Conclusion: SII and NLR might represent an early and easy prognostic marker in mCRPC patients treated with abiraterone. Further studies are needed to better define their impact and role in these patients.

Original languageEnglish
Article number376
JournalFrontiers in Pharmacology
Volume7
Issue numberOCT
DOIs
Publication statusPublished - Oct 13 2016

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Castration
Prostatic Neoplasms
Lymphocytes
Inflammation
Neutrophils
docetaxel
Blood Platelets
Survival
abiraterone
Neoplasm Metastasis
Prostate-Specific Antigen
Platelet Count
Software
Multivariate Analysis
Logistic Models
Regression Analysis
Confidence Intervals

Keywords

  • Abiraterone
  • CRPC
  • Prognostic factor
  • Prostate cancer
  • PSA
  • Systemic immune-inflammation index

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)

Cite this

Systemic immune-inflammation index predicts the clinical outcome in patients with mCRPC treated with abiraterone. / Lolli, Cristian; Caffo, Orazio; Scarpi, Emanuela; Aieta, Michele; Conteduca, Vincenza; Maines, Francesca; Bianchi, Emanuela; Massari, Francesco; Veccia, Antonello; Chiuri, Vincenzo E.; Facchini, Gaetano; De Giorgi, Ugo.

In: Frontiers in Pharmacology, Vol. 7, No. OCT, 376, 13.10.2016.

Research output: Contribution to journalArticle

Lolli, Cristian ; Caffo, Orazio ; Scarpi, Emanuela ; Aieta, Michele ; Conteduca, Vincenza ; Maines, Francesca ; Bianchi, Emanuela ; Massari, Francesco ; Veccia, Antonello ; Chiuri, Vincenzo E. ; Facchini, Gaetano ; De Giorgi, Ugo. / Systemic immune-inflammation index predicts the clinical outcome in patients with mCRPC treated with abiraterone. In: Frontiers in Pharmacology. 2016 ; Vol. 7, No. OCT.
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title = "Systemic immune-inflammation index predicts the clinical outcome in patients with mCRPC treated with abiraterone",
abstract = "Background: A systemic immune-inflammation index (SII) based on neutrophil (N), lymphocyte (L), and platelet (P) counts has shown a prognostic impact in several solid tumors. The aim of this study is to evaluate the prognostic role of SII in metastatic castration-resistant prostate cancer (mCRPC) patients treated with abiraterone post docetaxel. Patients and Methods: We retrospectively reviewed consecutive mCRPC patients treated with abiraterone after docetaxel in our Institutions. X-tile 3.6.1 software, cut-offvalues of SII, neutrophil-to-lymphocyte ratio (NLR) defined as N/L and platelets-to-lymphocyte ratio (PLR) as P/L. Overall survival (OS) and their 95{\%} Confidence Intervals (95{\%} CI) was estimated by the Kaplan-Meier method and compared with the log-rank test. The impact of SII, PLR, and NLR on overall survival (OS) was evaluated by Cox regression analyses and on prostate-specific antigen (PSA) response rates were evaluated by binary logistic regression. Results: A total of 230 mCRPC patients treated abiraterone were included. SII ≥ 535, NLR ≥ 3 and PLR ≥ 210 were considered as elevated levels (high risk groups. The median OS was 17.3 months, 21.8 months in SII < 535 group and 14.7 months in SII ≥ 535 (p < 0.0001). At univariate analysis Eastern Cooperative Oncology Group (ECOG) performance status, previous enzalutamide, visceral metastases, SII, NLR, and PLR predicted OS. In multivariate analysis, ECOG performance status, previous enzalutamide, visceral metastases, SII, and NLR remained significant predictors of OS [hazard ratio (HR) = 5.08, p < 0.0001; HR = 2.12, p = 0.009, HR = 1.77, 95{\%} p = 0.012; HR = 1.80, p = 0.002; and HR = 1.90, p = 0.001, respectively], whereas, PLR showed a borderline ability only (HR = 1.41, p = 0.068). Conclusion: SII and NLR might represent an early and easy prognostic marker in mCRPC patients treated with abiraterone. Further studies are needed to better define their impact and role in these patients.",
keywords = "Abiraterone, CRPC, Prognostic factor, Prostate cancer, PSA, Systemic immune-inflammation index",
author = "Cristian Lolli and Orazio Caffo and Emanuela Scarpi and Michele Aieta and Vincenza Conteduca and Francesca Maines and Emanuela Bianchi and Francesco Massari and Antonello Veccia and Chiuri, {Vincenzo E.} and Gaetano Facchini and {De Giorgi}, Ugo",
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T1 - Systemic immune-inflammation index predicts the clinical outcome in patients with mCRPC treated with abiraterone

AU - Lolli, Cristian

AU - Caffo, Orazio

AU - Scarpi, Emanuela

AU - Aieta, Michele

AU - Conteduca, Vincenza

AU - Maines, Francesca

AU - Bianchi, Emanuela

AU - Massari, Francesco

AU - Veccia, Antonello

AU - Chiuri, Vincenzo E.

AU - Facchini, Gaetano

AU - De Giorgi, Ugo

PY - 2016/10/13

Y1 - 2016/10/13

N2 - Background: A systemic immune-inflammation index (SII) based on neutrophil (N), lymphocyte (L), and platelet (P) counts has shown a prognostic impact in several solid tumors. The aim of this study is to evaluate the prognostic role of SII in metastatic castration-resistant prostate cancer (mCRPC) patients treated with abiraterone post docetaxel. Patients and Methods: We retrospectively reviewed consecutive mCRPC patients treated with abiraterone after docetaxel in our Institutions. X-tile 3.6.1 software, cut-offvalues of SII, neutrophil-to-lymphocyte ratio (NLR) defined as N/L and platelets-to-lymphocyte ratio (PLR) as P/L. Overall survival (OS) and their 95% Confidence Intervals (95% CI) was estimated by the Kaplan-Meier method and compared with the log-rank test. The impact of SII, PLR, and NLR on overall survival (OS) was evaluated by Cox regression analyses and on prostate-specific antigen (PSA) response rates were evaluated by binary logistic regression. Results: A total of 230 mCRPC patients treated abiraterone were included. SII ≥ 535, NLR ≥ 3 and PLR ≥ 210 were considered as elevated levels (high risk groups. The median OS was 17.3 months, 21.8 months in SII < 535 group and 14.7 months in SII ≥ 535 (p < 0.0001). At univariate analysis Eastern Cooperative Oncology Group (ECOG) performance status, previous enzalutamide, visceral metastases, SII, NLR, and PLR predicted OS. In multivariate analysis, ECOG performance status, previous enzalutamide, visceral metastases, SII, and NLR remained significant predictors of OS [hazard ratio (HR) = 5.08, p < 0.0001; HR = 2.12, p = 0.009, HR = 1.77, 95% p = 0.012; HR = 1.80, p = 0.002; and HR = 1.90, p = 0.001, respectively], whereas, PLR showed a borderline ability only (HR = 1.41, p = 0.068). Conclusion: SII and NLR might represent an early and easy prognostic marker in mCRPC patients treated with abiraterone. Further studies are needed to better define their impact and role in these patients.

AB - Background: A systemic immune-inflammation index (SII) based on neutrophil (N), lymphocyte (L), and platelet (P) counts has shown a prognostic impact in several solid tumors. The aim of this study is to evaluate the prognostic role of SII in metastatic castration-resistant prostate cancer (mCRPC) patients treated with abiraterone post docetaxel. Patients and Methods: We retrospectively reviewed consecutive mCRPC patients treated with abiraterone after docetaxel in our Institutions. X-tile 3.6.1 software, cut-offvalues of SII, neutrophil-to-lymphocyte ratio (NLR) defined as N/L and platelets-to-lymphocyte ratio (PLR) as P/L. Overall survival (OS) and their 95% Confidence Intervals (95% CI) was estimated by the Kaplan-Meier method and compared with the log-rank test. The impact of SII, PLR, and NLR on overall survival (OS) was evaluated by Cox regression analyses and on prostate-specific antigen (PSA) response rates were evaluated by binary logistic regression. Results: A total of 230 mCRPC patients treated abiraterone were included. SII ≥ 535, NLR ≥ 3 and PLR ≥ 210 were considered as elevated levels (high risk groups. The median OS was 17.3 months, 21.8 months in SII < 535 group and 14.7 months in SII ≥ 535 (p < 0.0001). At univariate analysis Eastern Cooperative Oncology Group (ECOG) performance status, previous enzalutamide, visceral metastases, SII, NLR, and PLR predicted OS. In multivariate analysis, ECOG performance status, previous enzalutamide, visceral metastases, SII, and NLR remained significant predictors of OS [hazard ratio (HR) = 5.08, p < 0.0001; HR = 2.12, p = 0.009, HR = 1.77, 95% p = 0.012; HR = 1.80, p = 0.002; and HR = 1.90, p = 0.001, respectively], whereas, PLR showed a borderline ability only (HR = 1.41, p = 0.068). Conclusion: SII and NLR might represent an early and easy prognostic marker in mCRPC patients treated with abiraterone. Further studies are needed to better define their impact and role in these patients.

KW - Abiraterone

KW - CRPC

KW - Prognostic factor

KW - Prostate cancer

KW - PSA

KW - Systemic immune-inflammation index

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DO - 10.3389/fphar.2016.00376

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