PD-1 inhibitor plus anlotinib for metastatic castration-resistant prostate cancer: a real-world study

Management and treatment of terminal metastatic castration-resistant prostate cancer(mCRPC)remains heavily debated.We sought to investigate the efficacy of programmed cell death 1(PD-1)inhibitor plus anlotinib as a potential solution for terminal mCRPC and further evaluate the association of genomic characteristics with efficacy outcomes.We conducted a retrospective real-world study of 25 mCRPC patients who received PD-1 inhibitor plus anlotinib after the progression to standard treatments.The clinical information was extracted from the electronic medical records and 22 patients had targeted circulating tumor DNA(ctDNA)next-generation sequencing.Statistical analysis showed that 6(24.0%)patients experienced prostate-specific antigen(PSA)response and 11(44.0%)patients experienced PSA reduction.The relationship between ctDNA findings and outcomes was also analyzed.DNA-damage repair(DDR)pathways and homologous recombination repair(HRR)pathway defects indicated a comparatively longer PSA-progressionfree survival(PSA-PFS;2.5 months vs 1.2 months,P=0.027;3.3 months vs 1.2 months,P=0.017;respectively).This study introduces the PD-1 inhibitor plus anlotinib as a late-line therapeutic strategy for terminal mCRPC.PD-1 inhibitor plus anlotinib may be a new treatment choice for terminal mCRPC patients with DDR or HRR pathway defects and requires further investigation.

Peripheral monocyte count： an independent diagnostic and prognostic biomarker for prostate cancer - a large Chinese cohort study

Increasing evidence indicates that inflammation may play important roles in tumorigenesis and progression, and an elevated peripheral monocyte count predicts a poor prognosis in various types of malignancies. Here, we evaluate the roles of peripheral monocyte count in the diagnosis and prognosis for prostate cancer in Chinese patients. A total of 1107 consecutive patients who had undergone prostate biopsy and 290 prostate cancer patients receiving androgen deprivation therapy as first-line therapy were retrospectively analyzed. The parameters were measured at the time of diagnosis. Univariate and multivariate logistic regression analyses were performed to identify the independent predictors of a positive biopsy. Patients were categorized in two groups using a cutoff point of 0.425 x 109 1-1 as calculated by the receiver-operating curve analysis for prognosis. Univariate and multivariate Cox regression analyses were performed to determine the associations of monocyte count with progression-free survival, cancer-specific survival, and overall survival. Multivariate logistic regression analyses showed that monocyte count, age, prostate-specific antigen （PSA）, free/total PSA, and prostate volume were independent predictors for prostate cancer. Multivariate Cox regression analyses identified an elevated monocyte count as an independent prognostic factor for worse cancer-specific survival （hazard ratio = 2.244, P 〈 0.05） and overall survival （hazard ratio = 1.995, P 〈 0.05）, but not progression-free survival （P = 0.117）. Our results indicated that an elevated monocyte count was an independent diagnostic biomarker for prostate cancer, and pretreatment peripheral monocyte count might play a significant role in the prognosis of prostate cancer patients treated with androgen deprivation therapy.