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Published on: March 6, 2018
Baseline Modified Glasgow Prognostic Score (mGPS) Predicts Radiologic Response and Overall Survival in Metastatic
Manuel Neuberger1, Janina Skladny2, Nora Goly2
1Department of Urology and Urologic Surgery, University Medical Center Mannheim (UMM), Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; manuel.neuberger@medma.uni-heidelberg.de.
Background/Aim:
To assess the baseline inflammatory markers modified Glasgow Prognostic Score (mGPS), systemic immune-inflammation index (SII), and neutrophile-to-lymphocyte ratio (NLR) as pragmatic tools for predicting response to chemohormonal therapy (docetaxel plus ADT) and prognosis in men with metastatic hormone-sensitive prostate cancer (mHSPC).
Patients And Methods:
Male patients who received docetaxel at a tertiary university care center between 2014 and 2019 were screened for completion of 6 cycles. NLR, SII, mGPS, overall survival (OS), three-year survival, and radiologic response were assessed. Complete response (CR), partial response (PR), and stable disease (SD) were analyzed alone and in combination.
Results:
Thirty-six mHSPC-patients were included. In thirty patients, baseline mGPS was assessed and was either 0 (n=22) or 2 (n=8). In Cochran-Armitage Trend Test, mGPS showed significant association with the combined radiologic endpoint of "CR, PR, or SD" (p=0.01), three-year survival (p=0.02), and OS (p<0.01). Next to prostate-specific antigen (PSA) (HR per 100 units 1.16, 95%CI=1.04-1.30, p<0.01), NLR (HR=1.31, 95%CI=1.03-1.66, p=0.03), and mGPS (2 vs. 0, HR=6.53, 95%CI=1.6-27.0, p<0.01) at baseline showed significant association with OS in univariable cox regression. However, mGPS remained the only independent predictor for OS in multivariable cox regression (p<0.01) and for the combined radiologic endpoint of "CR, PR or SD" (p=0.01) in multivariable logistic regression. SII showed no statistical relevance.
Conclusion:
Baseline mGPS seems to be a pragmatic tool for clinical decision-making in patients with mHSPC in daily routine.
Insights
The modified Glasgow Prognostic Score (mGPS) effectively predicts treatment response and survival in men with metastatic hormone-sensitive prostate cancer (mHSPC). This inflammatory marker is a valuable tool for clinical decisions in routine practice.
Area of Science:
- Oncology
- Inflammation Biomarkers
- Prostate Cancer Research
Background:
- Metastatic hormone-sensitive prostate cancer (mHSPC) requires effective prognostic tools.
- Inflammatory markers like mGPS, SII, and NLR are being investigated for their predictive value.
Purpose of the Study:
- To evaluate baseline inflammatory markers (mGPS, SII, NLR) for predicting chemohormonal therapy response and prognosis in mHSPC patients.
- To determine the pragmatic utility of these markers in clinical decision-making.
Main Methods:
- Retrospective analysis of 36 mHSPC patients treated with docetaxel plus androgen deprivation therapy (ADT).
- Assessment of baseline mGPS, SII, and NLR in relation to overall survival (OS), three-year survival, and radiologic response (CR, PR, SD).
Main Results:
- mGPS demonstrated a significant association with radiologic response (p=0.01), three-year survival (p=0.02), and OS (p<0.01).
- Baseline mGPS was the sole independent predictor for OS (multivariable Cox regression, p<0.01) and radiologic response (multivariable logistic regression, p=0.01).
- NLR showed association with OS in univariable analysis, while SII lacked statistical relevance.
Conclusions:
- Baseline mGPS is a pragmatic and independent predictor of outcomes in mHSPC patients.
- mGPS can aid clinical decision-making in the routine management of mHSPC.
