Oops, you're using an old version of your browser so some of the features on this page may not be displaying properly.

MINIMAL Requirements: Google Chrome 24+Mozilla Firefox 20+Internet Explorer 11Opera 15–18Apple Safari 7SeaMonkey 2.15-2.23

Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care

752 - The neutrophil-to-lymphocyte ratio (NLR) as a predictive marker of response to abiraterone acetate: a retrospective analysis of the COU302 study

Date

22 Oct 2018

Session

Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care

Topics

Tumour Site

Prostate Cancer

Presenters

Thomas LOUBERSAC

Citation

Annals of Oncology (2018) 29 (suppl_8): viii271-viii302. 10.1093/annonc/mdy284

Authors

T. LOUBERSAC1, S. Chakak2, M. Nguile-Makao2, V. Fradet2, P. Toren2

Author affiliations

  • 1 Urology, CHU de Nantes, 44093 - Nantes/FR
  • 2 Uro-oncology, CHU Hotel dieu quebec, QC G1R 2J6 - Quebec city/CA
More

Resources

Abstract 752

Background

The neutrophil–lymphocyte ratio (NLR) is recognized as a prognostic marker in many cancers, including metastatic castration-resistant prostate cancer (mCRPC). In this study, we perform a retrospective analysis of the pivotal COU302 study of abiraterone acetate (AA) as first line therapy for men mCRPC.

Methods

The COU302 study randomized men with minimally symptomatic mCRPC to 1000mg AA once daily plus 5mg prednisone (AA + P) twice daily or placebo plus 5mg prednisone (P) twice daily. We utilized Kaplan–Meier survival and cox proportional hazard analyses to assess the effect of baseline NLR on response to AA + P versus P. Adjustment co-variates were selected from a recently reported analysis of the PREVAIL study of enzalutamide in men with mCRPC. Based on this analysis, we selected a NLR cut-off value of 2.5. Outcomes assessed included the co-primary endpoints from the COU302 study overall survival (OS) , radiographic progression free-survival (RPFS) and PSA progression-free survival (PFS).

Results

Among the 1088 patients in the COU302 study, baseline NLR values showed significant differences according to baseline albumin below median (3.16 vs 2.92, p = 0.011), but no other baseline covariates. Mean NLR significantly increased following treatment initiation and at the end of study compared to baseline. Among patients with a baseline NLR ≥2.5, there was similar OS in AA + P and P treatment arms (p = 0.26), which was confirmed on adjusted cox proportional hazards (AA +P HR 0.95, p = 0.65). AA + P showed a significant OS benefit versus P (p = 0.0011) in men with baseline NLR <2.5, with an adjusted HR of 0.723(p = 0.012). For RPFS, benefits for AA + P were seen in men with NLR <2.5 or ≥ 2.5, with the magnitude of benefit greater in men with NLR <2.5. In the AA + P arm, men with baseline NLR <2.5 had significantly better PSA PFS compared to baseline NLR ≥2.5 (p = 0.03); no significant differences were seen in men in the placebo arm.

Conclusions

In the COU302 study, we observed that patients with a screening NLR<2.5 had a significant benefit to AA + P compared to P, whereas for patients with a screening NLR ≥2.5, this benefit was less evident. Increases in the NLR value from baseline could not be used to predict response to AA.

Clinical trial identification

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Editorial Acknowledgement

Disclosure

V. Fradet: Speaker: Abbvie, Bayer, Ferring, Janssen, Sanofi; Consultant: Amgen, AstraZeneca, Astellas, Bayer, Ferring, Janssen, Sanofi; Adviser: Amgen, Astellas, Bayer, Ferring, Janssen, Sanofi; Research grant: Amgen, AstraZeneca, Astellas, Janssen, Sanofi; Clinical trial: AstraZeneca, Bayer, Janssen; Meeting sponsor: Bayer, Janssen, Lilly; Educational grant: Janssen. P. Toren: Scientific study or trial: Innocrin Pharma, Roche; Consultant, Advisor: Sanofi Canada, Ferring, Astellas, Abbvie. All other authors have declared no conflicts of interest.

This site uses cookies. Some of these cookies are essential, while others help us improve your experience by providing insights into how the site is being used.

For more detailed information on the cookies we use, please check our Privacy Policy.

Customise settings
  • Necessary cookies enable core functionality. The website cannot function properly without these cookies, and you can only disable them by changing your browser preferences.