Basic Research - Cancer(구연) MP Session Ⅰ (MP-001) Geumkang Hall (Avenue 2F) 11월 28일(수) 16:00-17:00 거세저항성 전립선암 환자에서 도세탁셀과 androgen receptor axis-targeted agemts를 이용한 치료의 최적 시퀀싱 전략 : neutrophil-to-lymphocyte ratio의 활용 연세대학교 의과대학 강남세브란스병원 비뇨기과학교실 안현규, 구교철, 정병하 Objectives: To investigate the prognostic value of neutrophil-to-lymphocyte ratio (NLR) for the selection of the optimal sequencing strategy using docetaxel and androgen receptor axis-targeted (ARAT) agents in patients with castration-resistant prostate cancer (CRPC). Currently, there is a need to identify biomarkers to guide optimal sequential treatment in CRPC. Materials and Methods: This multi-center, retrospective analysis included 303 consecutive patients initially diagnosed with CRPC between September 2009 and March 2017. Of these, 52 (17.2%) patients received pre-docetaxel ARAT agents and 189 (62.4%) patients received post-docetaxel ARAT agents. The prognostic ability of NLR at CRPC diagnosis regarding radiographic progression-free survival (RFS) and cancer-specific survival (CSS) were investigated. For the analysis, the NLR level was dichotomized at 2.5, and evaluated according to sequencing strategy. Results: Multivariate analysis revealed NLR ≥2.5 as independent predictors of a lower risk for CSS. During the median follow-up of 16.0 months, patients with NLR ≥2.5 exhibited significantly lower 1-year RFS (p=0.007) and 2-year CSS rates (p=0.003) compared to patients with NLR <2.5. Among patients with NLR <2.5, the post-docetaxel ARAT agent sequencing group exhibited higher 1-year RFS (p=0.042) and 2-year CSS (p=0.006) rates compared to the pre-docetaxel ARAT agent sequencing group. Among patients with NLR ≥2.5, RFS and CSS rates were comparable regardless of ARAT agent sequencing. Conclusion: NLR ≥2.5 at CRPC diagnosis is associated with a lower risk for CSS. Patients with NLR <2.5 should primarily be offered docetaxel considering the survival benefit of docetaxel-to-ARAT agent sequencing. keywords : docetaxel; lymphocytes; neutrophils; prostatic neoplasms, castration-resistant; survival