绝对淋巴细胞计数可预测转移性 luminal 型乳腺癌患者接受 palbociclib 治疗的疗效。

Absolute lymphocyte count predicts efficacy of palbociclib in patients with metastatic luminal breast cancer.

机构信息

Department of Breast Medical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-Ku, Tokyo, 135-8550, Japan.

Department of Breast Surgical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-Ku, Tokyo, 135-8550, Japan.

出版信息

BMC Cancer. 2024 Sep 17;24(1):1156. doi: 10.1186/s12885-024-12941-z.

DOI:10.1186/s12885-024-12941-z

PMID:39289642

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11409475/

Abstract

BACKGROUND

Absolute lymphocyte count (ALC) is a predictive and prognostic factor for various tumor types, including breast cancer. Palbociclib is a CDK4/6 inhibitor widely used for the treatment of metastatic estrogen receptor (ER)-positive, HER2-negative breast cancer. However, predictive biomarkers of the efficacy of palbociclib remain unelucidated. We conducted a retrospective study to examine the predictive value of the baseline ALC in patients treated with palbociclib.

METHODS

The medical records of patients with ER-positive, HER2-negative breast cancer treated with palbociclib plus hormonal therapy between December 2017 and December 2021 were analyzed retrospectively. The cutoff value of ALC was set at 1800 cells/μL at the initiation of palbociclib treatment. The clinical benefit rate (CBR) was defined as the rate of complete or partial response or stable disease for at least 6 months. Progression-free survival (PFS) rates were estimated using the Kaplan-Meier method and compared using the log-rank test. Univariate and multivariate analyses were performed using Cox proportional hazards regression.

RESULTS

All of the 202 patients were women, with a median age of 59 years and a performance status (PS) of ≤ 2. The median numbers of lines of chemotherapy and endocrine therapy before palbociclib treatment were 0 (range, 0-9) and 1 (range, 0-7), respectively. Fifty-one patients had liver metastases. Forty-six patients tested negative for progesterone receptor (PgR) expression. The median follow-up time was 9.1 months. The CBR was significantly higher in the ALC-high group than in the ALC-low group (79% vs. 60%; P = 0.018). The median PFS was significantly longer in the ALC-high group than in the ALC-low group (26.8 months vs. 8.4 moths, respectively; P = 0.000013). ALC, age, PS, PgR status, prior chemotherapy, prior endocrine therapy, and liver metastasis were entered into the multivariate analysis. ALC was identified as an independent factor for PFS (P = 0.00085), along with liver metastasis (P = 0.0020), PS (P = 0.026), and prior endocrine therapy (P = 0.019).

CONCLUSION

ALC can serve as a predictor of palbociclib efficacy in patients with metastatic ER-positive, HER2-negative breast cancer.

摘要

背景

绝对淋巴细胞计数（ALC）是各种肿瘤类型的预测和预后因素，包括乳腺癌。帕博西尼（Palbociclib）是一种广泛用于治疗转移性雌激素受体（ER）阳性、HER2 阴性乳腺癌的 CDK4/6 抑制剂。然而，帕博西尼疗效的预测生物标志物仍未阐明。我们进行了一项回顾性研究，以检查 ALC 在接受帕博西尼治疗的患者中的预测价值。

方法

回顾性分析了 2017 年 12 月至 2021 年 12 月期间接受帕博西尼联合激素治疗的 ER 阳性、HER2 阴性乳腺癌患者的病历。将 ALC 的截断值设定为开始帕博西尼治疗时的 1800 个细胞/μL。临床获益率（CBR）定义为完全或部分缓解或稳定疾病至少 6 个月的比例。无进展生存期（PFS）率使用 Kaplan-Meier 方法估计，并使用对数秩检验进行比较。使用 Cox 比例风险回归进行单变量和多变量分析。

结果

所有 202 名患者均为女性，中位年龄为 59 岁，表现状态（PS）≤2。在接受帕博西尼治疗之前，中位数接受化疗和内分泌治疗的线数分别为 0（范围 0-9）和 1（范围 0-7）。51 名患者有肝转移。46 名患者孕激素受体（PgR）表达阴性。中位随访时间为 9.1 个月。ALC 高组的 CBR明显高于 ALC 低组（79% vs. 60%；P=0.018）。ALC 高组的中位 PFS 明显长于 ALC 低组（分别为 26.8 个月和 8.4 个月；P=0.000013）。ALC、年龄、PS、PgR 状态、既往化疗、既往内分泌治疗和肝转移均被纳入多变量分析。ALC 被确定为 PFS 的独立因素（P=0.00085），与肝转移（P=0.0020）、PS（P=0.026）和既往内分泌治疗（P=0.019）相关。