In patients with metastatic castration-resistant prostate cancer (mCRPC) treated with abiraterone acetate (AA) or enzalutamide, researchers sought to evaluate the prognostic relevance of pan-immune inflammation value (PIV).

The research included patients with mCRPC treated with AA or enzalutamide between January 2010 and June 2021. PIV was calculated using the most recent full blood count results from the month before therapy. Multivariate analysis was used to assess how overall survival (OS) and PIV related to one another. The PIV-LDH combination score was created by combining PIV and lactate dehydrogenase (LDH) values, which have demonstrated a survival impact in multivariate analysis.

The research had 114 patients in total. The median OS was 21 months (95% CI: 17.6–21.3) at the median follow-up of 34.6 months (95% CI: 32.4–36.8). In comparison to the high-PIV group, the median OS in the low-PIV group was considerably longer (34.4 months (95% CI: 21.3-47.5) vs. 14.3 months (95% CI: 10.0-18.7), P< 0.001). In the multivariate analysis for OS, high PIV (hazard ratio [HR]: 1.86, 95% CI: 1.11−3.13, P = 0.018) , and LDH values 1.5 times the upper limit of normal and higher (HR: 3.65 95%, CI: 1.86−7.16, P < 0.001) were linked to shorter OS. The median OS was 34.4 months (95% CI: 22.2-46.6) in the low-risk group, 17.7 months (95% CI: 11.7-23.6) in the intermediate-risk group, and 8.4 months (95% CI: 5.1-11.7) in the high-risk group when survival analysis was carried out using the PIV-LDH combination score (P< 0.001). The combined PIV and LDH score C-index was greater than the PIV score’s C-index (0.65 vs. 0.61).

In the investigation, they proved that PIV, in mCRPC patients treated with AA or enzalutamide, was a separate predictive factor for OS. A potential composite peripheral blood-based biomarker for OS prediction in such patients may also be the PIV-LDH combination score.

Reference: onlinelibrary.wiley.com/doi/10.1002/pros.24419