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 mUC. However, it remains unclear whether the FAN score is a prognostic...

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Main Authors: Yu Ishizuya, Atsunari Kawashima, Yuki Horibe, Akinaru Yamamoto, Masaru Tani, Akihiro Yoshimura, Liu Yutong, Sassi Nesrine, Toshiki Oka, Yohei Okuda, Toshihiro Uemura, Gaku Yamamichi, Takuji Hayashi, Yoshiyuki Yamamoto, Taigo Kato, Koji Hatano, Norio Nonomura
Format: Article
Language:English
Published: Nature Portfolio 2025-02-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-86212-7
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Summary: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 mUC. However, it remains unclear 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. Multivariable 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 2.56, 95% CI 1.62–4.05, 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 for mUC patients who are treated with platinum-based first-line chemotherapy.
ISSN:2045-2322