Dr. Abdurrahman Yurtaslan Ankara Oncology Hospital, Ankara 06560, Türkiye.
Curr Oncol. 2024 Sep 24;31(10):5722-5729. doi: 10.3390/curroncol31100424.
Currently, the combination of cyclin-dependent kinase 4/6 (CDK4/6) inhibitors and endocrine therapy is a first-line treatment for hormone-receptor-positive and HER2-negative metastatic breast cancer. This study aimed to assess the impact of changes in Mean Corpuscular Volume (MCV) on predicting responses to treatment and survival in patients with hormone-receptor-positive, HER2-negative metastatic breast cancer receiving CDK4/6 inhibitors and endocrine therapy.
Retrospectively, data on hemoglobin levels, MCV, B12, folate levels, and survival times were collected from 275 patients. Patients were categorized into two groups based on the degree of MCV change (delta MCV ≤ 10 vs. >10). Kaplan-Meier survival analysis was performed, with significance set at < 0.05.
The average age of the patients was 56.1 ± 12.1 years. In total, 72.7% received CDK4/6 inhibitors as first-line treatment, while 27.3% received them as second-line treatment. Before CDK4/6 inhibitor use, the median MCV level was 87.7 fL (IQR: 83-91), which increased to 98 fL (IQR: 92-103) after treatment ( < 0.001). ECOG performance score, CDK4/6 inhibitor treatment line, type of endocrine therapy, and MCV change were identified as independent predictors of progression-free survival in the Cox regression model. The median progression-free survival for the entire group was 28 months. Patients with MCV delta > 10 had a median progression-free survival of 33 months, compared to 23 months for those with MCV delta ≤ 10 ( = 0.029). There was no significant difference in median overall survival times between the two groups ( = 0.158).
This study highlights that patients with MCV delta > 10 had longer median progression-free survival compared to those with MCV delta ≤ 10.
目前，细胞周期蛋白依赖性激酶 4/6（CDK4/6）抑制剂与内分泌治疗联合应用是激素受体阳性、HER2 阴性转移性乳腺癌的一线治疗方法。本研究旨在评估平均红细胞体积（MCV）变化对接受 CDK4/6 抑制剂和内分泌治疗的激素受体阳性、HER2 阴性转移性乳腺癌患者治疗反应和生存的预测作用。
回顾性收集了 275 例患者的血红蛋白水平、MCV、B12、叶酸水平和生存时间数据。根据 MCV 变化程度（delta MCV≤10 与>10）将患者分为两组。采用 Kaplan-Meier 生存分析，显著性水平设为<0.05。
患者的平均年龄为 56.1±12.1 岁。72.7%的患者接受 CDK4/6 抑制剂作为一线治疗，27.3%的患者作为二线治疗。在使用 CDK4/6 抑制剂之前，中位 MCV 水平为 87.7fL（IQR：83-91），治疗后升高至 98fL（IQR：92-103）（<0.001）。ECOG 表现评分、CDK4/6 抑制剂治疗线、内分泌治疗类型和 MCV 变化被确定为 Cox 回归模型中无进展生存期的独立预测因素。全组中位无进展生存期为 28 个月。MCV delta>10 的患者中位无进展生存期为 33 个月，而 MCV delta≤10 的患者为 23 个月（=0.029）。两组中位总生存期无显著差异（=0.158）。
本研究表明，MCV delta>10 的患者中位无进展生存期长于 MCV delta≤10 的患者。
