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Inicio Actas Urológicas Españolas (English Edition) Prognostic nutritional index is an independent prognostic factor for treatment r...
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Vol. 46. Issue 5.
Pages 301-309 (June 2022)
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Vol. 46. Issue 5.
Pages 301-309 (June 2022)
Original article
Prognostic nutritional index is an independent prognostic factor for treatment response, survival and drug choice in metastatic castration-resistant prostate cancer treated with abiraterone acetate or enzalutamide
El índice nutricional pronóstico como factor pronóstico independiente para la respuesta al tratamiento, la supervivencia y la elección del fármaco en el cáncer de próstata metastásico resistente a la castración tratado con acetato de abiraterona o enzalutamida
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A. Küçükarda
Corresponding author
ahmetkucukarda22@gmail.com

Corresponding author.
, A. Gökyer, İ. Gökmen, E. Özcan, M.B. Hacıoğlu, B. Erdoğan, S. Uzunoğlu, İ. Çiçin
Division of Medical Oncology, Department of Internal Medicine, Trakya University School of Medicine, Edirne, Turkey
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Tables (4)
Table 1. Characteristics and demographic features of study subjects.
Table 2. Comparison of patients characteristics between abiraterone acetate and enzalutamide groups.
Table 3. Comparison of treatment response and survival of PNI groups according to Abiraterone acetate and enzalutamide subgroups.
Table 4. Univariate and multivariate analyses of clinical features for PSA-progression free survival, radiologic progression free survival and overall survival.
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Abstract
Purpose

We designed this study to identify the prognostic value of baseline prognostic nutritional index (PNI) in metastatic castration-resistant prostate cancer (mCRPC) patients treated with abiraterone acetate or enzalutamide.

Methods

101 mCRPC patients were included. PNI was calculated using formula 10 x serum albumin value (gr/dL) + 0.005 × total lymphocyte count (per mm3). ROC analysis was used for determining prognostic PNI value.

Results

The statistically significant cut-off value for PNI was 46.62. Initial PSA response and PSA kinetics (early PSA response and 30 %–50%–90% PSA response at any time) were much better in PNI > 46.62 group than the PNI ≤ 46.62 group (p < 0.01). In multivariate analysis, baseline PNI level >46.62 was an independent predictor of PSA-PFS (HR: 0.42, p < 0.01), radiologic PFS (HR: 0.53, p < 0.01), and OS (HR: 0.42, p < 0.01). In the PNI ≤ 46.62 group, median OS was 7.4 months (95% CI: 4.1–10.7) for the abiraterone acetate subgroup vs. 17.6 months (95% CI: 10.1–25.1) for enzalutamide subgroups (p < 0.01).

Conclusion

PNI is a useful, independent prognostic marker for mCRPC patients treated with either abiraterone acetate or enzalutamide. Using pre-treatment PNI may help clinicians in the prediction of survival and decision making based on abiraterone acetate or enzalutamide.

Keywords:
Prognostic nutritional index
Abiraterone acetate
Enzalutamide
Castration-resistant prostate cancer
Resumen
Objetivo

El objetivo del presente fue identificar el valor pronóstico del índice nutricional pronóstico (INP) basal en pacientes con cáncer de próstata resistente a la castración metastásico (CPRCm) tratados con acetato de abiraterona o enzalutamida.

Métodos

Se incluyeron 101 pacientes de CPRCm. El INP se calculó mediante la fórmula 10 x valor de albúmina sérica (gr/dL) + 0,005 × recuento total de linfocitos (mm3). Se utilizó el análisis ROC para determinar el valor pronóstico del INP.

Resultados

El valor de corte estadísticamente significativo para el INP fue 46,62. La respuesta inicial del PSA y la cinética del PSA (respuesta precoz por PSA y respuesta por PSA del 30%–50%–90% en cualquier momento) fueron mucho mejores en el grupo INP > 46,62 que en el grupo INP ≤ 46,62 (p < 0,01). En el análisis multivariante, el INP basal >46,62 fue un predictor independiente de la SLP por PSA (HR: 0,42, p < 0,01), la SLP radiológica (HR: 0,53, p < 0,01) y la SG (HR: 0,42, p < 0,01). En el grupo de INP ≤ 46,62, la mediana de la SG fue de 7,4 meses (IC 95%: 4,1–10,7) para el subgrupo de acetato de abiraterona, frente a 17,6 meses (IC 95%: 10,1–25,1) para los subgrupos de enzalutamida (p < 0,01).

Conclusión

El INP es un marcador pronóstico útil e independiente para los pacientes con CPRCm tratados con acetato de abiraterona o enzalutamida. El uso del INP previo al tratamiento puede ayudar a los médicos en la predicción de la supervivencia y en la elección de acetato de abiraterona o enzalutamida.

Palabras clave:
Índice nutricional pronóstico
Acetato de abiraterona
Enzalutamida
Cáncer de próstata resistente a la castración

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