The FAN score predicts prognosis after platinum-based first-line chemotherapy in patients with metastatic urothelial carcinoma

Abstract

We have reported that the FAN score, which consists of the fibrosis-4 (Fib-4) index, albumin–bilirubin (ALBI) score, and neutrophil-lymphocyte ratio (NLR), is a prognostic marker for patients receiving pembrolizumab for metastatic urothelial carcinoma (mUC). However, the insight into whether the FAN score is a prognostic factor for platinum-based first-line chemotherapy. We included 126 patients with mUC who received platinum-based first-line chemotherapy. The median PFS and overall survival (OS) were 6.3 months (95% confidence interval [CI]: 4.5 – 8.0) and 14.0 months (95% CI: 11.1 – 16.9), respectively. Multivariate analysis showed that Fib-4 index (HR 3.85, 95% CI 1.09 – 13.58, p = 0.036), ALBI score (HR 1.53, 95% CI 1.01 – 2.31, p = 0.045), and NLR (HR 1.76, 95% CI 1.14 – 2.71, p = 0.010) were independently associated with PFS. The FAN score was also associated with PFS (HR 2.52, 95% CI 1.60 – 3.98, p < 0.001). The median PFS for patients with low FAN score (≤1) and those with high FAN score (≥2) were 7.8 (95% CI 5.0 – 9.0) months and 3.0 (95% CI 1.6 – 5.8) months, respectively. In conclusion, the FAN score is a prognostic factor in patients with mUC treated with platinum-based first-line chemotherapy.