Yamamoto Misato, Shibata Masahiro, Tanaka Aya, Tsunoda Nobuyuki, Masuda Norikazu
Department of Breast and Endocrine Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, Aichi, 466-8550, Japan.
Depatment of Surgery, Nagoya Ekisaikai Hospital, 4-66 Shounen-Cho, Nakagawa-Ku, Nagoya, Aichi, 454-8502, Japan.
Surg Today. 2025 Feb;55(2):188-196. doi: 10.1007/s00595-024-02893-z. Epub 2024 Jul 4.
Cyclin-dependent kinase 4/6 inhibitors have been used in endocrine therapy for patients with estrogen receptor (ER)-positive and human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer. Although randomized trials have shown that combined therapies prolong progression-free survival (PFS) in comparison to endocrine monotherapy, the predictors of efficacy are unknown. This study aimed to identify the blood test parameters to predict the effects of palbociclib and endocrine therapy.
Seventy-nine patients treated with palbociclib and endocrine therapy between December 2017 and June 2022 were reviewed. We assessed PFS in patients according to factors evaluated based on patient characteristics and peripheral blood tests.
Patients in the C-reactive protein (CRP)-high, lactate dehydrogenase (LDH)-high, and albumin (Alb)-low groups had significantly shorter PFS than those in the normal group. A multivariate analysis revealed that high LDH and low Alb levels were independent factors that affected PFS. The Alb-low group had an inferior disease control rate. Patients in the CRP-high, LDH-high, and Alb-low groups who received these therapies as first- or second-line treatments showed poor PFS.
Several predictors of the efficacy of palbociclib and endocrine therapy were identified in the peripheral blood test parameters of patients with ER-positive and HER2-negative subtypes of metastatic breast cancer.
细胞周期蛋白依赖性激酶4/6抑制剂已用于雌激素受体(ER)阳性和人表皮生长因子受体2(HER2)阴性转移性乳腺癌患者的内分泌治疗。尽管随机试验表明,与内分泌单药治疗相比,联合治疗可延长无进展生存期(PFS),但疗效的预测因素尚不清楚。本研究旨在确定预测哌柏西利和内分泌治疗效果的血液检测参数。
回顾了2017年12月至2022年6月期间接受哌柏西利和内分泌治疗的79例患者。我们根据基于患者特征和外周血检测评估的因素来评估患者的PFS。
C反应蛋白(CRP)高、乳酸脱氢酶(LDH)高和白蛋白(Alb)低组患者的PFS明显短于正常组。多变量分析显示,高LDH和低Alb水平是影响PFS的独立因素。Alb低组的疾病控制率较差。接受这些治疗作为一线或二线治疗的CRP高、LDH高和Alb低组患者的PFS较差。
在ER阳性和HER2阴性亚型转移性乳腺癌患者的外周血检测参数中,确定了几种哌柏西利和内分泌治疗疗效的预测因素。