Department of Breast Surgery, National Hospital Organization Hokkaido Cancer Center, 2-3-54, Kikusuishijo, Shiroishi-ku, Sapporo, Hokkaido, 003-0804, Japan.
Division of Breast Oncology, Saitama Cancer Center, Kitaadachi-gun, Saitama, Japan.
Breast Cancer. 2021 Jul;28(4):945-955. doi: 10.1007/s12282-021-01232-1. Epub 2021 Mar 7.
It was reported that eribulin regulates the tumor microenvironment, including the immune system, by inducing vascular remodeling. Lymphocyte counts are a critical index of immune response in patients. The non-Asian, global EMBRACE study has suggested that baseline absolute lymphocyte count (ALC) may be a predictor of the survival benefit of eribulin in breast cancer patients. We examined whether the baseline ALC is a potential predictor of overall survival (OS) in Japanese patients with HER2-negative advanced breast cancer treated with eribulin.
This was a post hoc analysis of data from a post-marketing observational study of eribulin in Japan. The OS by baseline ALC was estimated using the Kaplan-Meier method, with the cut-off value of 1500/μL for ALC. The OS by baseline neutrophil-to-lymphocyte ratio (NLR), a general prognostic index in breast cancer patients, was also estimated, with the cut-off value of 3.
The median OS was longer in patients with an ALC of ≥ 1500/μL than in those with an ALC of < 1500/μL (19.4 vs. 14.3 months; hazard ratio [HR]: 0.628; 95% confidence interval [CI]: 0.492, 0.801). Patients with an NLR of ≥ 3 showed shorter OS than those with an NLR of < 3 (13.2 vs. 18.8 months; HR: 1.552; 95% CI 1.254, 1.921), and NLR also separated OS in patients with an ALC of < 1500/μL.
Consistent with the findings of a previous study involving a non-Asian, Western population, our study suggested that baseline ALC may be a predictive factor for the survival benefit of eribulin in Japanese patients.
据报道，表柔比星通过诱导血管重塑来调节肿瘤微环境，包括免疫系统。淋巴细胞计数是患者免疫反应的关键指标。非亚洲的全球 EMBRACE 研究表明，基线绝对淋巴细胞计数（ALC）可能是表柔比星治疗乳腺癌患者生存获益的预测指标。我们研究了表柔比星治疗的 HER2 阴性晚期乳腺癌日本患者的基线 ALC 是否是总生存期（OS）的潜在预测指标。
这是一项在日本进行的表柔比星上市后观察性研究的事后分析。使用 Kaplan-Meier 方法估计基线 ALC 的 OS，ALC 的截止值为 1500/μL。还估计了基线中性粒细胞与淋巴细胞比值（NLR）的 OS，NLR 是乳腺癌患者的一般预后指标，其截止值为 3。
ALC≥1500/μL 的患者中位 OS 长于 ALC<1500/μL 的患者（19.4 个月 vs. 14.3 个月；风险比 [HR]：0.628；95%置信区间 [CI]：0.492，0.801）。NLR≥3 的患者 OS 短于 NLR<3 的患者（13.2 个月 vs. 18.8 个月；HR：1.552；95% CI 1.254，1.921），NLR 也分离了 ALC<1500/μL 的患者的 OS。
与涉及非亚洲西方人群的先前研究结果一致，我们的研究表明，基线 ALC 可能是表柔比星治疗日本患者生存获益的预测因素。
