Neutrophil-to-lymphocyte ratio(NLR) may predict response to firstlineabiraterone treatment in menwith metastatic castration-resistantprostate cancer (mCRPC), accordingto study findings presented atthe European Society for MedicalOncology 2018 congress in Munich,Germany.

In a retrospective analysis of theCOU302 trial, which comparedabiraterone-prednisone therapy withprednisone-placebo therapy in menwith minimally symptomatic mCRPC,investigators found that patients witha baseline NLR less than 2.5, butnot 2.5 or higher, derived significantbenefit in terms of overall survival(OS) from abiraterone-prednisonecompared with prednisone-placebo.Among men with a baseline NLRbelow 2.5, patients who receivedabiraterone had a significant 28%decreased risk of death in adjustedanalyses compared with those in theplacebo arm, Thomas Loubersac,MD, of CHU de Nantes, Nantes,France, and colleagues reported. 

With respect to radiographicprogression-free survival, men inboth NLR groups experienced benefitfrom abiraterone, with the magnitudeof benefit greater among those withan NLR below 2.5, according to theinvestigators.

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Among patients receiving abiraterone,those with a baseline NLRbelow 2.5 had significantly betterPSA progression-free survivalcompared with patients who had abaseline NLR of 2.5 or higher. Theinvestigators observed no significantdifferences in the placebo arm.The study by Dr Loubersac’s teamincluded 1088 patients who wererandomly assigned to receive either1000 mg of abiraterone once dailyplus 5 mg of prednisone twice dailyor placebo plus 5 mg of prednisonetwice daily. Mean NLR valuesincreased significantly after treatmentinitiation and the end of thestudy compared with baseline.

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