Scientific Reports (Feb 2025)

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

  • 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

DOI
https://doi.org/10.1038/s41598-025-86212-7
Journal volume & issue
Vol. 15, no. 1
pp. 1 – 12

Abstract

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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.

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