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外周血白细胞指标可预测日本接受艾立布林治疗的乳腺癌患者的总生存期更长。

Indices of peripheral leukocytes predict longer overall survival in breast cancer patients on eribulin in Japan.

机构信息

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.

出版信息

Breast Cancer. 2021 Jul;28(4):945-955. doi: 10.1007/s12282-021-01232-1. Epub 2021 Mar 7.

Abstract

BACKGROUND

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.

METHODS

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.

RESULTS

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.

CONCLUSIONS

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.

摘要

背景

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。

方法

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。

结果

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。

结论

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/674b/8213560/3d3ce7a1621a/12282_2021_1232_Fig1_HTML.jpg

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