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Posted by on Apr 3, 2017 in Prostate cancer | 0 comments

In a nutshell

The aim of this study was to determine whether the neutrophil to lymphocyte ratio (NLR) can be used to determine outcome in CRPC patients treated with enzalutamide (Xtandi).

It was concluded that NLR could be used to predict the outcome for CRPC patients treated with enzalutamide

Some background

Treatment for metastatic prostate cancer (spread beyond the prostate) often includes hormone therapy. This treatment reduces the levels of male hormones, such as testosterone, needed for cancer growth. Over time, some patients become resistant to this treatment. This is known as metastatic castration resistant prostate cancer (mCRPC).

Enzalutamide is a treatment for mCRPC. It reduces the levels of testosterone and helps to prevent the cancer from growing and spreading further.

The NLR can be useful in predicting outcome for a patient with metastatic CRPC.  Neutrophils and lymphocytes are types of white blood cells (cells that protect the body against disease). It is not clear whether the NLR can be used to determine the outcome for patients treated with enzalutamide

Methods & findings

The records of 193 men with mCRPC were examined. The average NLR before the study began (baseline NLR) was 3.2. The patients had previously been treated with the chemotherapy docetaxel (Taxotere). Patients were treated with 160 mg of enzalutamide a day. The change in NLR was measured after 4 and 12 weeks. Patients were followed for an average of 11.7 months.

The average progression free survival (PFS, time from treatment until disease progression) was 3.2 months for those with baseline NLR greater than 3. The PFS for those with baseline NLR 3 or less was 7.4 months.

The average overall survival (OS, time from treatment until death from any cause) for those with baseline NLR greater than 3 was 10.4 months and in those with baseline NLR 3 or less was 16.9 months.

Changes seen in NLR at 4 weeks after treatment could predict PFS and OS for patients with metastatic CRPC. 

The bottom line

This study concluded that changes in the NLR could predict outcome in patients with mCRPC.

What’s next?

If you are considering enzalutamide as a treatment, ask your physician about your NLR ratio. 

Published By :


Date :

Jul 19, 2016

Original Title :

Persistent Neutrophil to Lymphocyte Ratio >3 during Treatment with Enzalutamide and Clinical Outcome in Patients with Castration-Resistant Prostate Cancer.

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