Abiraterone Outcomes Tied to NLR

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For example, men with a baseline NLR below 2.5, patients who received abiraterone had a significant 28% decreased risk of death.
For example, men with a baseline NLR below 2.5, patients who received abiraterone had a significant 28% decreased risk of death.

Neutrophil-to-lymphocyte ratio (NLR) may predict response to firstline abiraterone treatment in men with metastatic castration-resistant prostate cancer (mCRPC), according to study findings presented at the European Society for Medical Oncology 2018 congress in Munich, Germany.

In a retrospective analysis of the COU302 trial, which compared abiraterone-prednisone therapy with prednisone-placebo therapy in men with minimally symptomatic mCRPC, investigators found that patients with a baseline NLR less than 2.5, but not 2.5 or higher, derived significant benefit in terms of overall survival (OS) from abiraterone-prednisone compared with prednisone-placebo. Among men with a baseline NLR below 2.5, patients who received abiraterone had a significant 28% decreased risk of death in adjusted analyses compared with those in the placebo arm, Thomas Loubersac, MD, of CHU de Nantes, Nantes, France, and colleagues reported. 

With respect to radiographic progression-free survival, men in both NLR groups experienced benefit from abiraterone, with the magnitude of benefit greater among those with an NLR below 2.5, according to the investigators.

Among patients receiving abiraterone, those with a baseline NLR below 2.5 had significantly better PSA progression-free survival compared with patients who had a baseline NLR of 2.5 or higher. The investigators observed no significant differences in the placebo arm. The study by Dr Loubersac's team included 1088 patients who were randomly assigned to receive either 1000 mg of abiraterone once daily plus 5 mg of prednisone twice daily or placebo plus 5 mg of prednisone twice daily. Mean NLR values increased significantly after treatment initiation and the end of the study compared with baseline.

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