Conteduca V, et al. - The goal of this study was to examine the tie-up between metabolic syndrome (MS) and inflammation (INF) and its effect on progression-free/overall survival (PFS/OS) in metastatic castration-resistant prostate cancer (mCRPC) treated with abiraterone or enzalutamide. Findings revealed that pretreatment detection of MS and INF alterations could depict as an available and easy instrument for better prognostication of patients with mCRPC.

Methods

• The enrollment consisted of patients with mCRPC from 7 Italian Institutes between March 2011 and October 2016.
• Herein, MS was defined by modified adult treatment panel-III criteria.
• Experts characterized INF by at least one of these criteria: Neutrophil to lymphocyte ratio ≥ 3, elevated erythrocyte sedimentation rate or C-reactive protein.

Results

• It was determined that 83 of 551 (15.1%) patients met MS criteria at baseline and 34 (6.2%) during treatment.
• A greater INF profile was found in MS patients (MS+) compared to MS- (P < 0.0001).
• Data illustrated that the median PFS was 3.7 for MS+ vs 8.7 months for MS- (hazard ratio [HR] = 2.77; 95% CI: 2.12-3.61; P < 0.0001).
• Median OS was discovered to be 6.9 and 19 months in MS+ and MS-, respectively (HR = 3.43; 95% CI: 2.56-4.58; P < 0.0001).
• INF resulted in shorter PFS and OS (4.5 vs 8.5 months, HR = 1.48, 95% CI: 1.15-1.90, P=0.002, and 11.2 vs 18.8 months, HR =1.66, 95% CI: 1.26-2.18, P=0.0003, respectively).
• As per the outcomes, MS plus INF provided the identification of high-risk prognostic group (MS+/INF+ vs MS-/INF-) with worse PFS (3.7 vs 9 months, HR = 2.7, 95% CI: 1.88-3.89, P < 0.0001) and OS (6.3 vs 20.4 months, HR = 4.04, 95% CI: 2.75-5.93, P < 0.0001).
• An indepent link was brought to light between MS with PFS (HR = 2.07; 95% CI: 1.03-4.18; P=0.041) and OS (HR = 4.87; 95% CI: 2.36-10.03; P < 0.0001) in the multivariable analysis.
• The association between MS/INF was highlighted due to the absence of INF as an independent predictor of survival.