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

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.