Department of Surgery, Division of Breast and Endocrine Surgery, School of Medicine, Hyogo Medical University, 1-1 Mukogawa-Cho, Nishinomiya, Hyogo, 663-8501, Japan.
Int J Clin Oncol. 2024 Dec;29(12):1850-1859. doi: 10.1007/s10147-024-02625-w. Epub 2024 Sep 15.
The aim of this study was to elucidate the clinical significance of peripheral blood biomarkers, including absolute lymphocyte count (ALC) and neutrophil-to-lymphocyte ratio (NLR), at the end of treatment (EOT) with CDK4/6 inhibitors abemaciclib and palbociclib in patients with estrogen receptor-positive human epidermal growth factor receptor 2-negative advanced breast cancer.
We included 67 patients treated with fulvestrant plus abemaciclib or palbociclib. Overall survival (OS) since the EOT with CDK/4/6 inhibitors was compared in relation to the levels of ALC and NLR. The cut-off values of ALC and NLR were set at 1000/μL and 3, respectively.
Patients with a high ALC at EOT showed significantly longer OS than those with a low ALC (p = 0.0358). Moreover, patients with a low NLR at EOT showed significantly longer OS than those with a high NLR at EOT (p = 0.0044). Looking at the changes of ALC and NLR between baseline and the EOT, patients with a high ALC both at baseline and at the EOT showed significantly longer OS than others (p = 0.0201). Similarly, patients with a low NLR both at baseline and at the EOT showed significantly longer OS after EOT than others (p = 0.0136). Multivariable analysis revealed that the NLR at EOT (low vs. high) and changes in NLR (low at baseline to low at EOT vs. others) were significant and independent prognostic factors for OS after EOT (p = 0.0337, p = 0.0039, respectively).
NLR at EOT with CDK4/6 inhibitors is a significant and independent prognostic marker for patients with ER-positive HER2-negative advanced breast cancer.
本研究旨在阐明 CDK4/6 抑制剂 abemaciclib 和 palbociclib 治疗结束时（EOT）外周血生物标志物（包括绝对淋巴细胞计数[ALC]和中性粒细胞与淋巴细胞比值[NLR]）的临床意义，这些患者为雌激素受体阳性人表皮生长因子受体 2 阴性的晚期乳腺癌患者。
我们纳入了 67 例接受氟维司群联合 abemaciclib 或 palbociclib 治疗的患者。比较了 EOT 时 CDK/4/6 抑制剂的总生存期（OS）与 ALC 和 NLR 水平的关系。将 ALC 和 NLR 的截止值分别设定为 1000/μL 和 3。
EOT 时 ALC 较高的患者 OS 明显长于 ALC 较低的患者（p=0.0358）。此外，EOT 时 NLR 较低的患者 OS 明显长于 EOT 时 NLR 较高的患者（p=0.0044）。观察基线和 EOT 时 ALC 和 NLR 的变化，基线和 EOT 时 ALC 均较高的患者 OS 明显长于其他患者（p=0.0201）。同样，EOT 时 NLR 均较低的患者 EOT 后 OS 明显长于其他患者（p=0.0136）。多变量分析显示，EOT 时 NLR（低 vs. 高）和 NLR 变化（低基线至低 EOT vs. 其他）是 EOT 后 OS 的显著且独立的预后因素（p=0.0337，p=0.0039）。
EOT 时的 NLR 是 ER 阳性 HER2 阴性晚期乳腺癌患者的一个重要且独立的预后标志物。
