Prognostic value of pretreatment lung immune prognostic index in patients with metastatic hormone-sensitive and castration-resistant prostate cancer.

Authors

null

Zhipeng Wang

Department of Urology, West China Hospital, Sichuan University, Chengdu, China

Zhipeng Wang , Haoyang Liu , Jinge Zhao , Pengfei Shen , Hao Zeng

Organizations

Department of Urology, West China Hospital, Sichuan University, Chengdu, China, West China Hospital, Sichuan University, Chengdu Sichuan, China, Department of Urology, West China Hospital, Chengdu, China, West China Hospital, Sichuan University, Chengdu, China, H3 Biomedicine Inc., Cambridge, MA

Research Funding

Other Government Agency
National Natural Science Foundation of China

Background: The aim of this study was to explore the prognostic value of the lung immune prognostic index (LIPI) in patients with metastatic hormone-sensitive prostate cancer (mHSPC) and metastatic castration-resistant prostate cancer (mCRPC). Methods: We retrospectively analyzed data of 502 mHSPC patients primarily treated with maximal androgen blockade and 158 mCRPC patients receiving abiraterone. All cases were classified into the LIPI-Good, LIPI-Intermediate, and LIPI-Poor groups based on their LIPI score calculated by the derived neutrophil-to-lymphocyte ratio and lactate dehydrogenase. The potential of LIPI in predicting mCRPC-free survival (CFS), PSA response, PSA-progression-free survival (PSA-PFS), and overall survival (OS) were analyzed. A propensity score matching (PSM) methodology was performed to balance the baseline factors of different groups. Results: In the mHSPC cohort, patients of the LIPI-Good (mCFS: 25.7 mo; mOS: 93.3 mo), LIPI-Intermediate (mCFS: 14.8 mo; mOS: 51.9 mo) and LIPI-Poor group (mCFS: 6.8 mo; mOS: 18.5 mo) had sequentially worse clinical outcomes (P<0.001 for all pairwise comparisons). The results remain consistent after PSM. Multivariate Cox regression further confirmed that LIPI was an independent predictor of survival outcomes. Subgroup analysis verified that LIPI was associated with unfavorable prognosis in all subgroups except for cases with visceral metastases or receiving abiraterone/docetaxel. As for patients with CRPC receiving abiraterone, LIPI was also an indicator of poor prognosis. Specifically, cases in the LIPI-Good, LIPI-Intermediate and LIPI-Poor group had a ladder-shaped worse PSA response (71.4% [50/70] vs. 56.5% [39/69] vs. 36.8% [7/12], P=0.015), PSA-PFS (14.9- vs. 9.3 vs. 3.1 mo, P<0.001) and OS (14.6- vs. 32.3- vs. 53.4 mo, P<0.001). The results were robust even after PSM. Multivariate Cox regression confirmed that LIPI was an independent prognosticator of abiraterone. Conclusions: This study demonstrated that baseline LIPI was a significant prognostic biomarker for both mHSPC and mCRPC patients and could potentially facilitate risk classification and treatment-decision making in clinical practice.

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Abstract Details

Meeting

2023 ASCO Genitourinary Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session A: Prostate Cancer

Track

Prostate Cancer - Advanced,Prostate Cancer - Localized

Sub Track

Translational Research, Tumor Biology, Biomarkers, and Pathology

Citation

J Clin Oncol 41, 2023 (suppl 6; abstr 198)

DOI

10.1200/JCO.2023.41.6_suppl.198

Abstract #

198

Poster Bd #

G10

Abstract Disclosures