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    Prognostic nutritional index is an independent prognostic factor for treatment response, survival and drug choice in metastatic castration-resistant prostate cancer treated with abiraterone acetate or enzalutamide
    (Elsevier Espana, 2022) Kucukarda, A.; Gokyer, A.; Gokmen, I; Ozcan, E.; Hacioglu, M. B.; Erdogan, B.; Uzunoglu, S.
    Purpose: We designed this study to identify the prognostic value of baseline prognostic nutritional index (PNI) in metastatic castration-resistant prostate cancer (mCRPC) patients treated with abiraterone acetate or enzalutamide. Methods: One hundred one mCRPC patients were included. PNI was calculated using formula 10 x serum albumin value (g/dl) + .005 x total lymphocyte count (per mm(3)). ROC analysis was used for determining prognostic PNI value. Results: The statistically significant cut-off value for PNI was 46.62. Initial PSA response and PSA kinetics (early PSA response and 30-50%-90% PSA response at any time) were much better in PNI>46.62 group than the PNI <= 46.62 group (P<.01). In multivariate analysis, baseline PNI level >46.62 was an independent predictor of PSA-PFS (HR: .42; P<.01), radiologic PFS (HR: .53; P<.01), and OS (HR: .42; P<.01). In the PNI <= 46.62 group, median OS was 7.4 months (95% CI: 4.1-10.7) for the abiraterone acetate subgroup vs. 17.6 months (95% CI: 10.1-25.1) for enzalutamide subgroups (P<.01). Conclusion: PNI is a useful, independent prognostic marker for mCRPC patients treated with either abiraterone acetate or enzalutamide. Using pre-treatment PNI may help clinicians in the prediction of survival and decision making based on abiraterone acetate or enzalutamide. (C) 2021 AEU. Published by Elsevier Espana, S.L.U. All rights reserved.