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Pretreatment neutrophil to lymphocyte ratio as prognostic factor in metastatic breast cancer treated with cyclin dependent kinase 4/6 inhibitors
BACKGROUND: Cyclin dependent kinase inhibitors (CdK4/6i) changed the course of hormone receptor positive (HR+) HER2 negative (HER2-) metastatic breast cancer (mBC). To date, no factors have been shown to predict response to CdK4/6i. Neutrophil-to-lymphocyte ratio (NLR), an indicator of the host syst...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9893782/ https://www.ncbi.nlm.nih.gov/pubmed/36741710 http://dx.doi.org/10.3389/fonc.2022.1105587 |
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author | Rottier, Pauline Emile, George Johnson, Alison Levy, Christelle Allouache, Djelila Hrab, Ioana Segura, Carine Morel, Adeline Villemin, Maud Dubot-Poitelon, Coraline Boismoreau, Louis Cherifi, François Lequesne, Justine Da Silva, Angélique |
author_facet | Rottier, Pauline Emile, George Johnson, Alison Levy, Christelle Allouache, Djelila Hrab, Ioana Segura, Carine Morel, Adeline Villemin, Maud Dubot-Poitelon, Coraline Boismoreau, Louis Cherifi, François Lequesne, Justine Da Silva, Angélique |
author_sort | Rottier, Pauline |
collection | PubMed |
description | BACKGROUND: Cyclin dependent kinase inhibitors (CdK4/6i) changed the course of hormone receptor positive (HR+) HER2 negative (HER2-) metastatic breast cancer (mBC). To date, no factors have been shown to predict response to CdK4/6i. Neutrophil-to-lymphocyte ratio (NLR), an indicator of the host systemic inflammatory response, is an independent prognostic factor for survival in cancers. We conducted this study to evaluate the impact of NLR on survival in mBC patients treated with first line CdK4/6i. METHODS: All mBC patients treated with first line CdK4/6i between November 2015 and December 2019 were retrospectively included. The biomarker threshold was defined using ROC curves. We analyzed progression free survival (PFS), overall survival (OS), 12-month PFS and response rate according to NLR in univariable and multivariable analysis. RESULTS: A total of 126 patients treated with palbociclib (n=101), ribociclib (n=18) or abemaciclib (n=7) were included, with a median follow-up of 33 months [range: 2.9–57]. Median age was 65 years [29-86], 40% patients had good performance status (ECOG-PS 0). Most patients (71%) were included at the metastatic relapse stage and 29% had only bone metastases. Median PFS and median OS were 27 and 51 months, respectively. High NLR (≥ 2.53) was significantly associated with worse PFS (Hazard Ratio (HR)=0.50, CI(95%) = [0.32–0.79]) and worse OS (HR=0.45, [CI(95%): 0.23–0.87]). In multivariable analysis, NLR and ECOG PS were independently factors associated with PFS (p=0.016 and p=0.001, respectively). CONCLUSION: High NLR was associated with worse PFS and OS in HR+ HER2- mBC patients treated with first line CdK4/6i. NLR is a reliable and inexpensive prognostic marker, easily accessible in routine clinical practice, which could help optimize the therapeutic strategy. These results need to be confirmed in larger prospective studies. |
format | Online Article Text |
id | pubmed-9893782 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-98937822023-02-03 Pretreatment neutrophil to lymphocyte ratio as prognostic factor in metastatic breast cancer treated with cyclin dependent kinase 4/6 inhibitors Rottier, Pauline Emile, George Johnson, Alison Levy, Christelle Allouache, Djelila Hrab, Ioana Segura, Carine Morel, Adeline Villemin, Maud Dubot-Poitelon, Coraline Boismoreau, Louis Cherifi, François Lequesne, Justine Da Silva, Angélique Front Oncol Oncology BACKGROUND: Cyclin dependent kinase inhibitors (CdK4/6i) changed the course of hormone receptor positive (HR+) HER2 negative (HER2-) metastatic breast cancer (mBC). To date, no factors have been shown to predict response to CdK4/6i. Neutrophil-to-lymphocyte ratio (NLR), an indicator of the host systemic inflammatory response, is an independent prognostic factor for survival in cancers. We conducted this study to evaluate the impact of NLR on survival in mBC patients treated with first line CdK4/6i. METHODS: All mBC patients treated with first line CdK4/6i between November 2015 and December 2019 were retrospectively included. The biomarker threshold was defined using ROC curves. We analyzed progression free survival (PFS), overall survival (OS), 12-month PFS and response rate according to NLR in univariable and multivariable analysis. RESULTS: A total of 126 patients treated with palbociclib (n=101), ribociclib (n=18) or abemaciclib (n=7) were included, with a median follow-up of 33 months [range: 2.9–57]. Median age was 65 years [29-86], 40% patients had good performance status (ECOG-PS 0). Most patients (71%) were included at the metastatic relapse stage and 29% had only bone metastases. Median PFS and median OS were 27 and 51 months, respectively. High NLR (≥ 2.53) was significantly associated with worse PFS (Hazard Ratio (HR)=0.50, CI(95%) = [0.32–0.79]) and worse OS (HR=0.45, [CI(95%): 0.23–0.87]). In multivariable analysis, NLR and ECOG PS were independently factors associated with PFS (p=0.016 and p=0.001, respectively). CONCLUSION: High NLR was associated with worse PFS and OS in HR+ HER2- mBC patients treated with first line CdK4/6i. NLR is a reliable and inexpensive prognostic marker, easily accessible in routine clinical practice, which could help optimize the therapeutic strategy. These results need to be confirmed in larger prospective studies. Frontiers Media S.A. 2023-01-19 /pmc/articles/PMC9893782/ /pubmed/36741710 http://dx.doi.org/10.3389/fonc.2022.1105587 Text en Copyright © 2023 Rottier, Emile, Johnson, Levy, Allouache, Hrab, Segura, Morel, Villemin, Dubot-Poitelon, Boismoreau, Cherifi, Lequesne and Da Silva https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Oncology Rottier, Pauline Emile, George Johnson, Alison Levy, Christelle Allouache, Djelila Hrab, Ioana Segura, Carine Morel, Adeline Villemin, Maud Dubot-Poitelon, Coraline Boismoreau, Louis Cherifi, François Lequesne, Justine Da Silva, Angélique Pretreatment neutrophil to lymphocyte ratio as prognostic factor in metastatic breast cancer treated with cyclin dependent kinase 4/6 inhibitors |
title | Pretreatment neutrophil to lymphocyte ratio as prognostic factor in metastatic breast cancer treated with cyclin dependent kinase 4/6 inhibitors |
title_full | Pretreatment neutrophil to lymphocyte ratio as prognostic factor in metastatic breast cancer treated with cyclin dependent kinase 4/6 inhibitors |
title_fullStr | Pretreatment neutrophil to lymphocyte ratio as prognostic factor in metastatic breast cancer treated with cyclin dependent kinase 4/6 inhibitors |
title_full_unstemmed | Pretreatment neutrophil to lymphocyte ratio as prognostic factor in metastatic breast cancer treated with cyclin dependent kinase 4/6 inhibitors |
title_short | Pretreatment neutrophil to lymphocyte ratio as prognostic factor in metastatic breast cancer treated with cyclin dependent kinase 4/6 inhibitors |
title_sort | pretreatment neutrophil to lymphocyte ratio as prognostic factor in metastatic breast cancer treated with cyclin dependent kinase 4/6 inhibitors |
topic | Oncology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9893782/ https://www.ncbi.nlm.nih.gov/pubmed/36741710 http://dx.doi.org/10.3389/fonc.2022.1105587 |
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