Baseline basophil and basophil-to-lymphocyte status is associated with clinical outcomes in metastatic hormone sensitive prostate cancer.
Agreen Hadadi, Katherine Er Smith, Limeng Wan, Jacqueline R Brown, Greta Russler, Lauren Yantorni, Sarah Caulfield, Jennifer Lafollette, Melvin Moore, Omer Kucuk, Bradley Carthon, Bassel Nazha, Yuan Liu, Mehmet A Bilen
Author Information
Agreen Hadadi: Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA.
Katherine Er Smith: Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA.
Limeng Wan: Departments of Biostatistics and Bioinformatics, Emory University, Atlanta, GA.
Jacqueline R Brown: Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA; Department of Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA.
Greta Russler: Department of Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA.
Lauren Yantorni: Department of Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA.
Sarah Caulfield: Department of Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA.
Jennifer Lafollette: Grady Cancer Center for Excellence, Grady Memorial Hospital, Atlanta, GA.
Melvin Moore: Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA; Department of Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA; Grady Cancer Center for Excellence, Grady Memorial Hospital, Atlanta, GA.
Omer Kucuk: Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA; Department of Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA; Grady Cancer Center for Excellence, Grady Memorial Hospital, Atlanta, GA.
Bradley Carthon: Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA; Department of Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA; Grady Cancer Center for Excellence, Grady Memorial Hospital, Atlanta, GA.
Bassel Nazha: Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA; Department of Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA; Grady Cancer Center for Excellence, Grady Memorial Hospital, Atlanta, GA.
Yuan Liu: Departments of Biostatistics and Bioinformatics, Emory University, Atlanta, GA.
Mehmet A Bilen: Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA; Department of Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA; Grady Cancer Center for Excellence, Grady Memorial Hospital, Atlanta, GA. Electronic address: mehmet.a.bilen@emory.edu.
BACKGROUND: Biomarkers have the potential to provide clinical guidance, but there is limited data for biomarkers in metastatic hormone sensitive prostate cancer (mHSPC). METHODS: We performed a retrospective multicenter review from Winship Cancer Institute at Emory University and Georgia Cancer Center for Excellence at Grady Memorial Hospital (2014-2020) in the United States of America (USA). We collected demographics, disease characteristics, and laboratory data, including complete blood counts (CBC) at the start of upfront therapy. We evaluated overall survival (OS) and progression-free survival (PFS) associated with baseline lab values. RESULTS: 165 patients were included with a median follow-up time of 33.5 months (mo). 105 (63.6%) had Gleason scores of 8-10 and 108 (65.9%) were classified as high-volume disease. 92 patients received upfront docetaxel (55.8%) and 73 received upfront abiraterone (44.2%). Univariate analyses (UVA) and multivariable analyses (MVA) identified worse clinical outcomes (CO) associated with elevated basophils and basophil-to-lymphocyte ratio (BLR). Based on MVA, elevated basophils (defined as ≥0.1, optimal cut) were associated with a hazard ratio (HR) of 3.51 (95% CI 1.65-7.43, P 0.001) for OS and HR of 1.88 (95% CI 1.05-3.38, P 0.034) for PFS. Our MVA also found that BLR ≥0.0142 was associated with HR 2.11 (95% CI 1.09-4.10, P 0.028) for OS; however, PFS was not statistically significant. CONCLUSION: We conclude that elevated baseline basophils and BLR are associated with worse clinical outcomes in mHSPC. Although results require further validation, BLR is a potential prognostic biomarker.
