950 - The effect of neutrophil to lymphocyte ratio (NLR) prior to taxotere-based chemotherapy in patients (pts) with metastatic castration resistant prost...

Date 28 September 2012
Event ESMO Congress 2012
Session Publication Only
Topics Prostate Cancer
Presenter Avishay Sella
Authors A. Sella1, T. Sella2, S. Kovel1
  • 1Oncology, Asaf Harofeh Medical Center, 73100 - Beer Jacob/IL
  • 2Oncology, SHEBA MEDICAL CENTER, 52621 - Ramat Gan/IL

Abstract

Introduction

Increasing evidence supports the involvement of systemic inflammation in cancer development and progression. Neutrophiles/lymphocytes ration (NLR), a marker of inflammatory response which is associated with poor outcome in colorectal, gastric, pancreas, hepatocellular, breast, lung and renal cancer cases. The improved survival with immunotherapy (Provenge) in mCRPC and the recent report that high NLR in associated with poor outcome in mCRPC treated with ketoconazole prompted the evaluation of NLR in such pt's treated with Taxotere-based chemotherapy.

Methods

During the last decade we treated 62 mCRPC pt's with Taxotere-based chemotherapy. Blood counts up to 2 month prior to therapy without infection or steroid treatment are available in 31 pt's. Statistical analysis was performed with SPSS17, survival curve was measured with Kaplan-Meyer curve.

Results

Patient's characteristics: median age-70 (55-82) years, median PSA-95.2 (1.6-2316), median alkaline phosphatase- 123(10.8-1795)U/ml was elevated (> 115 U/ml) in 18 pt's (58%) and median hemoglobin-12.1(8.4-15.4) with anemia (< 12 gr/%) in 15 pt's (48%). Median survival was 15.8 + 2.2 months (mo.) while PSA response (> 50% decline) occurred in 14 pt's (45.1%). Eighteen pts (58%) had NLR > 3.0. The two groups were similar in PSA, alkaline phosphatase elevated levels and PSA response. We observed no difference in survival nor PFS between the pt's with NLR> 3.0 and NLR < 3.0; 17.1 v.s 13.7 mo. and 5.4 v.s 4.5 mo. respectively. Analysis according to alkaline phosphatase, hemoglobin levels, elevated PSA and alkaline phosphatase or PSA response was non-significant.

Conclusions

Unlike other cancers, elevated NLR in mCRPC treated with Taxotere-based chemotherapy does not predict worse outcome.

Disclosure

All authors have declared no conflicts of interest.