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Revealing the prognostic landscape of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in metastatic castration-resistant prostate cancer patients treated with abiraterone or enzalutamide: a meta-analysis

Prostate Cancer and Prostatic Diseases volume 23, pages 220–231 (2020)Cite this article

Subjects

Abstract

Background

The neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR), as markers of systematic inflammation response, have been reported to be indicators in metastatic castration-resistant prostate cancer (mCRPC), whereas their prognostic values remain conflict. This study was to assess the prognostic value of NLR and PLR in mCRPC patients and to assess the response of abiraterone or enzalutamide through using NLR and PLR.

Methods

Databases searching was conducted in the PubMed, EMBASE, Google Scholar, and the Cochrane Library for relevant published literature up to October 2019. Data extraction and quality evaluation were performed on the eligible studies. STATA 14.0 software was used to pooled hazard ratios (HRs) and their 95% confidence intervals (CIs) for overall survival (OS) and progression-free survival (PFS).

Results

A total of 3144 mCRPC patients were enrolled from 15 cohort studies in this meta-analysis. The pooled results demonstrated that elevated NLR had a significant association with inferior OS in mCRPC patients treated with abiraterone (HR = 1.63, 95% CI: 1.43–1.85, P < 0.001) and enzalutamide (HR = 1.48, 95% CI: 1.27–1.72, P < 0.001), whereas elevated NLR had no significant association with unfavorable PFS treated with abiraterone and enzalutamide, respectively. Elevated PLR had a significant association with an inferior OS (HR = 1.52, 95% CI: 1.16–1.98, P < 0.001) in mCRPC patients treated with abiraterone.

Conclusions

NLR and PLR were effective biomarkers for predicting prognosis in mCRPC patients and served as indicators of the efficacy of personalized treatment of mCRPC using abiraterone or enzalutamide. Future, more randomized control trials (RCTs) are needed to investigate the promising value of hematologic parameters.

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Fig. 1
Fig. 2: Forest plots of pooled NLR on OS in mCRPC patients.
Fig. 3
Fig. 4: Forest plots of pooled NLR on PFS in mCRPC patients.
Fig. 5
Fig. 6: Sensitivity analysis and Egger's test of pooled NLR on OS in mCRPC patients.

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Acknowledgements

We greatly acknowledge Prof. Qianyun Tang, from Central South University, for her excellent advice on the paper.

Funding

This study was funded by the National Natural Science Foundation of China (Grant Number: 81772754) and the Guangdong Provincial Natural Science Foundation-Major Basic Research and Cultivation Project, China (Grant Number: 2017A030308009).

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  1. These authors contributed equally: Yupeng Guan, Haiyun Xiong

Authors and Affiliations

  1. Department of Urology, the Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, 518107, China

    Yupeng Guan, Haiyun Xiong, Yupeng Feng, Guolong Liao, Tongyu Tong & Jun Pang

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Conceptualization: YG and HX. Methodology: YG, YF, and GL. Writing, editing, and revision: YG. Supervision and review: JP.

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Correspondence to Jun Pang.

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Guan, Y., Xiong, H., Feng, Y. et al. Revealing the prognostic landscape of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in metastatic castration-resistant prostate cancer patients treated with abiraterone or enzalutamide: a meta-analysis. Prostate Cancer Prostatic Dis 23, 220–231 (2020). https://doi.org/10.1038/s41391-020-0209-3

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