The prognosis for patients with metastatic castration-resistant prostate cancer (mCRPC) varies, being influenced by blood-related factors such as transcriptional profiling and immune cell ratios. We aimed to address the contribution of distinct whole blood immune cell components to the prognosis of these patients. This study analyzed pre-treatment blood samples from 152 chemotherapy-naive mCRPC patients participating in a phase 2 clinical trial (NCT02288936) and a validation cohort. We used CIBERSORT-X to quantify 22 immune cell types and assessed their prognostic significance using Kaplan–Meier and Cox regression analyses. Reduced CD8 T-cell proportions and elevated monocyte levels were substantially connected with a worse survival. High monocyte counts correlated with a median survival of 32.2 months versus 40.3 months for lower counts (HR: 1.96, 95% CI 1.11–3.45). Low CD8 T-cell levels were associated with a median survival of 31.8 months compared to 40.3 months for higher levels (HR: 1.97, 95% CI 1.11–3.5). These findings were consistent in both the trial and validation cohorts. Multivariate analysis further confirmed the independent prognostic value of CD8 T-cell counts. This study highlights the prognostic implications of specific blood immune cells, suggesting they could serve as biomarkers in mCRPC patient management and should be further explored in clinical trials.
转移性去势抵抗性前列腺癌（mCRPC）患者的预后存在差异，并受到转录谱分析和免疫细胞比例等血液相关因素的影响。本研究旨在探讨不同全血免疫细胞成分对这些患者预后的影响。研究分析了来自一项二期临床试验（NCT02288936）及验证队列中152例未接受过化疗的mCRPC患者的治疗前血液样本。我们使用CIBERSORT-X量化了22种免疫细胞类型，并通过Kaplan-Meier和Cox回归分析评估了它们的预后意义。CD8 T细胞比例降低和单核细胞水平升高与较差的生存率显著相关。高单核细胞计数的患者中位生存期为32.2个月，而低计数患者为40.3个月（HR：1.96，95% CI 1.11–3.45）。低CD8 T细胞水平的患者中位生存期为31.8个月，而高水平患者为40.3个月（HR：1.97，95% CI 1.11–3.5）。这些发现在试验队列和验证队列中均保持一致。多变量分析进一步证实了CD8 T细胞计数的独立预后价值。本研究强调了特定血液免疫细胞的预后意义，表明它们可作为mCRPC患者管理中的生物标志物，并应在临床试验中进一步探索。
肿瘤(癌症)患者之家