Does NLR PLR MLR MPV indicate anything for HSPC/CRPC guys?

[kainasar]

This study seems pretty good in showing the ratios as biomarkers for PC.

jcancer.org/v14p0519.pdf

Mine are over the averages Ive looked at so far. So will keep looking for research reports.

This study looks at similar biomarkers for lung cancer, that may be of interest.

tlcr.amegroups.org/article/...

[PCaWarrior]

PLR is loosely predictive. MLR and MPV not much at all. NLR... What are your values?

NLR appears the most robust for predicting HSPC->CRPC. Much more predictive than the others.

I've written some things about the following. Thanks for prodding me to look into NLR again.

I had a sucky 2024. Hardly worked out. Got fat 225->300. Didn't eat right. My NLR at the start of the year was 3.9. Then I started working out and eating right - lost over 50 lbs this year and almost 30 in March alone. My NLR dropped to 3.1, then 2.43, last week 2.24.

Ways to decrease inflammation (and NLR):

Increase:

Omega 3 (e.g fatty fish, Lovaza)

Fruits and Berries

Veggies

Fiber

Healthy Fats

Mediterranean Diet

Exercise - Heavy or intense

D3 (not too much)

Measure NLR when fasted (12+ hours) and 48+ hours after exercise

Do not smoke, Overweight is bad too.

[Justfor_ in reply to PCaWarrior]

Don't ask me about the source as many years have passed since I researched it, but on my excel I have noted cut-off for NLR >3.0

[PCaWarrior in reply to Justfor_]

Not sure if that's why you choose it or not but that's the normal UL. It's not perfectly characterized (what is?). The cutoff in this meta study pmc.ncbi.nlm.nih.gov/articl... is 3.3. 3.0 sounds reasonable. Likely result in an earlier prediction and take care of lab variability.

[Justfor_ in reply to PCaWarrior]

No, it isn't there signifying the normal upper limit. It is there to gage inflammation and I remember that a good/safe value is below 2.5.

[PCaWarrior in reply to Justfor_]

I'm sort of confused. You said you noted 3.0 which happens to be the normal UL.

Do you use 3.0 or 2.5?

NLR >3.3 was linked to 50% worse CRPC (HR=1.5).

I use these inflammation markers to check my inflammation and see if it is low. If it isn't, I try to reduce it. I'm not CRPC. There are many that aren't quantifiable. My PSADT from nadirs is 19 months. But that has very little to do with the growth of my cancer. I can pick a nadir value and an SPA value and easily get a PSADT of a week or less. Or vice versa, and get a 50% regression on the order of days.

[Justfor_ in reply to PCaWarrior]

3.0 is the cut-off meaning that above this is an indication that things are moving towards a bad prognosis.

2.5 and below is relax you are in a safe area.

It is a trustworthy indicator. I will compile for you my average values since 1994. Cancer development and progression is evident.

[PCaWarrior in reply to Justfor_]

Thanks. Buffer zone? I often use different zones and then have excel color them differently depending on the number. Bright red - danger danger Will Robinson. Light red, not great but imminent danger not signaled. My coloring is like the alerts on Star Trek. I want to code an application to sound warning sirens.

Love to see your NLR values over time. Do you happen to have PSA too? Did NLR signal issues before PSA?

I'm looking into SpO2, HRV, sleep, etc. Any thoughts?

Can any of these smartwatch measurements indicate PCa progress?

• SpO2

• Gait speed change

• Gait speed

• Moderate-Vigorous Activity (MVPA)

• Heart Rate Variability (HRV)

• Daily step count

• Sleep efficiency

• Resting heart rate

• Step count variance

• BP (sys/dia)

• Pulse Rate

• Glucose snapshot

• Ketones snapshot

Others?

[Justfor_ in reply to PCaWarrior]

a) Baseline, 1988-2015,

N=13, Avg = 2.28, SD= 0.54

PSA = 2.5 (N=1)

b) Shortly before RP, 2018-2019,

N=2, Avg = 4.46, SD= 0.05

PSA = 7.2 to 10.4 (N=4)

c) 2.5 years post RP - no treatment - PSADT 9.5 mo, 2019-2021,

N=29, Avg = 3.25, SD= 0.54

PSA = 0.02 to 0.17 (N=29)

d) 3.3 years on MED Bicalutamide, 2021-2025,

N=37, Avg = 2.95, SD= 0.35

PSA = 0.09 to 0.005 (N=37)

[dhccpa in reply to PCaWarrior]

My lymphocytes crashed after starting radiation in November. Finished radiation in January and lymphocytes now seem to be increasing it not back to normal yet. Anything to worry about?

Prior to radiation, my NLR had been 2.0-2.5 for years.

[PCaWarrior in reply to dhccpa]

I don't think so.

Lymphocytes frequently decrease after RT. And it often takes months or even a year or two for them to recover. I'd just monitor them quarterly to make sure they're recovering.

Your NLR before RT was good and I'd guess you'd approach that again. Good baseline.

Your MO might have some thoughts also. Maybe ask your RO too?

[dhccpa in reply to PCaWarrior]

I have! They now think I know more than they do, because of the questions I ask, based on your contributions here! Actually, they are general oncologists, and their lack of cutting edge knowledge about metastatic PCa has really been showing lately.

[kainasar]

Found two studies and discussion of NLR and PLR as predictors of bone mets

jurolsurgery.org/articles/c...

pubmed.ncbi.nlm.nih.gov/301...

In this study a remarkable significance is shown between NLR and PLR ratio levels and PC progression.

journals.lww.com/indianjcan...

Relationship between neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) in peripheral blood and prognosis after castration therapy for prostate cancer

Patients with low NLR had significantly better progression-free survival than the high NLR group, and patients with low PLR had significantly better progression-free survival than the high PLR group, with statistical significance (P < 0.05). The area under the curve for NLR and PLR in predicting progression-free survival after castration therapy for prostate cancer was both greater than 0.90, indicating high clinical utility.

[PCaWarrior in reply to kainasar]

Maybe context dependent? I found a study that showed high NLR predicts better BCR but worse OS. And I found a study that showed high PLR is not indicative one way or the other. Most of the studies show high inflammation is bad.

I'm not going to lose sleep over it. I'm going to try to keep my inflammation low. Exercise and a Mediterranean diet help. A decent D status helps as well as omega 3 fatty acids are also helpful.