Istanbul Research and Training Hospital, Department of Medical Oncology, Istanbul, Turkey.
Bakirkoy Dr. Sadi Konuk Research and Training Hospital, Department of Medical Oncology, Istanbul, Turkey.
Breast. 2024 Dec;78:103820. doi: 10.1016/j.breast.2024.103820. Epub 2024 Oct 10.
Cyclin Dependent Kinase (CDK) 4-6 inhibitors are the recommended first-line treatment option for hormone-positive metastatic breast cancer (MBC). They show their effects by causing cell cycle arrest in G1-S phase. Neutropenia is the most common haematological side effect. In the literature, data on the association between CDK 4-6 inhibitors and macrocytosis are limited. We aimed to investigate the effect of macrocytosis on survival.
We retrospectively analysed 133 patients with de novo hormone positive MBC using CDK 4-6 inhibitors in first line treatment. Mean Corpuscular Volume (MCV) > 100 was considered macrocytosis and patients were divided into two groups; MCV<100 and MCV >100. The association of macrocytosis with clinicopathological features, Progression Free Survival (PFS) and Overall Survival (OS) were evaluated.
42 patients were receiving palbociclib and 81 patients were receiving ribociclib. Median OS was determined as 33 months and median PFS was determined as 22 months. Macrocytosis ever rate was 45.8 % during follow-up. Macrocytosis was observed in 4.2 % of the patients in the first month, 16.7 % in the third month, 41.6 % in the sixth month and 42.2 % in the twelfth month. ER receptor level, ki-67, macrocytosis at 6-12 months and macrocytosis-ever which were found to affect OS as a result of univariate Cox regression analysis, were evaluated with multivariate Cox regression models and it was observed that they had significant effect on PFS and OS.
Macrocytosis may be a useful biomarker for the prediction of PFS and OS in MBC patients receiving CDK 4-6 inhibitors.
细胞周期蛋白依赖性激酶（CDK）4-6 抑制剂是激素阳性转移性乳腺癌（MBC）的首选一线治疗选择。它们通过在 G1-S 期引起细胞周期停滞来发挥作用。中性粒细胞减少症是最常见的血液学副作用。在文献中，关于 CDK 4-6 抑制剂与巨红细胞症之间关联的数据有限。我们旨在研究巨红细胞症对生存的影响。
我们回顾性分析了 133 例使用 CDK 4-6 抑制剂作为一线治疗的初治激素阳性 MBC 患者。平均红细胞体积（MCV）>100 被认为是巨红细胞症，患者分为两组；MCV<100 和 MCV>100。评估巨红细胞症与临床病理特征、无进展生存期（PFS）和总生存期（OS）的相关性。
42 例患者接受帕博西尼治疗，81 例患者接受瑞博西尼治疗。中位 OS 确定为 33 个月，中位 PFS 确定为 22 个月。随访期间巨红细胞症发生率为 45.8%。在第一个月观察到巨红细胞症的发生率为 4.2%，第三个月为 16.7%，第六个月为 41.6%，第十二个月为 42.2%。ER 受体水平、ki-67、6-12 个月时的巨红细胞症和巨红细胞症的发生，经单因素 Cox 回归分析结果显示与 OS 相关，经多因素 Cox 回归模型评估发现与 PFS 和 OS 显著相关。
巨红细胞症可能是预测接受 CDK 4-6 抑制剂的 MBC 患者 PFS 和 OS 的有用生物标志物。
