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Research ArticleClinical Studies

Absolute Lymphocyte Count Is an Independent Prognostic Factor for ER-positive HER2-negative Advanced Breast Cancer Patients Treated With CDK4/6 Inhibitors

HARUKA KANAOKA, MASAYUKI NAGAHASHI, YUSA ATAKE, AKIRA HATTORI, AYAKO BUN, REIKO FUKUI, HIROMI OZAWA, YUKIE FUJIMOTO, TOMOKO HIGUCHI, KEIKO NATORI, MICHIKO IMAMURA, KEIKO MURASE, YUICHI TAKATSUKA and YASUO MIYOSHI
Anticancer Research October 2022, 42 (10) 4867-4878; DOI: https://doi.org/10.21873/anticanres.15992
HARUKA KANAOKA
Department of Surgery, Division of Breast and Endocrine Surgery, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
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MASAYUKI NAGAHASHI
Department of Surgery, Division of Breast and Endocrine Surgery, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
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  • For correspondence: ma-nagahashi@hyo-med.ac.jp
YUSA ATAKE
Department of Surgery, Division of Breast and Endocrine Surgery, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
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AKIRA HATTORI
Department of Surgery, Division of Breast and Endocrine Surgery, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
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AYAKO BUN
Department of Surgery, Division of Breast and Endocrine Surgery, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
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REIKO FUKUI
Department of Surgery, Division of Breast and Endocrine Surgery, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
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HIROMI OZAWA
Department of Surgery, Division of Breast and Endocrine Surgery, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
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YUKIE FUJIMOTO
Department of Surgery, Division of Breast and Endocrine Surgery, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
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TOMOKO HIGUCHI
Department of Surgery, Division of Breast and Endocrine Surgery, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
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KEIKO NATORI
Department of Surgery, Division of Breast and Endocrine Surgery, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
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MICHIKO IMAMURA
Department of Surgery, Division of Breast and Endocrine Surgery, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
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KEIKO MURASE
Department of Surgery, Division of Breast and Endocrine Surgery, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
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YUICHI TAKATSUKA
Department of Surgery, Division of Breast and Endocrine Surgery, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
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YASUO MIYOSHI
Department of Surgery, Division of Breast and Endocrine Surgery, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
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Abstract

Background/Aim: The aim of this study was to elucidate the clinical significance of peripheral blood biomarkers, including absolute lymphocyte count (ALC), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and C-reactive protein (CRP) in patients with estrogen receptor-positive human epidermal growth factor receptor 2-negative advanced breast cancer treated with the CDK4/6 inhibitors, abemaciclib and palbociclib. Patients and Methods: A total of 83 patients treated with fulvestrant plus abemaciclib or palbociclib were included in this study. Progression-free survival (PFS) and overall survival (OS) were compared in relation to baseline levels of ALC, NLR, PLR and CRP. Results: The cut-off values of ALC, NLR, PLR, and CRP for PFS were determined from the receiver operating characteristic curve using the Youden index for area under the curve and set at 1,212/μl, 1.964, 170 and 0.220 mg/dl, respectively. In the abemaciclib-treated group, ALC-high patients showed significantly better PFS than ALC-low patients (p=0.0151) and multivariate analysis revealed that ALC was an independent prognostic factor for PFS (p=0.0085). In the palbociclib-treated group, there was no significant relationship between any peripheral blood biomarkers and PFS. In both treatment groups, ALC-high patients showed significantly better OS than ALC-low patients (p=0.0169 and 0.0290, respectively). Multivariate analysis revealed ALC was an independent prognostic factor for OS in both abemaciclib- and palbociclib-treated groups (p=0.0112 and 0.0202, respectively). Conclusion: ALC is an independent prognostic factor for estrogen receptor-positive human epidermal growth factor receptor 2-negative advanced breast cancer patients treated with the CDK4/6 inhibitors abemaciclib and palbociclib.

Key Words:
  • Advanced breast cancer
  • CDK4/6 inhibitor
  • peripheral blood biomarker
  • absolute lymphocyte count
  • prognostic factor
  • Received July 24, 2022.
  • Revision received August 8, 2022.
  • Accepted August 9, 2022.
  • Copyright © 2022 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.
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Anticancer Research: 42 (10)
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Absolute Lymphocyte Count Is an Independent Prognostic Factor for ER-positive HER2-negative Advanced Breast Cancer Patients Treated With CDK4/6 Inhibitors
HARUKA KANAOKA, MASAYUKI NAGAHASHI, YUSA ATAKE, AKIRA HATTORI, AYAKO BUN, REIKO FUKUI, HIROMI OZAWA, YUKIE FUJIMOTO, TOMOKO HIGUCHI, KEIKO NATORI, MICHIKO IMAMURA, KEIKO MURASE, YUICHI TAKATSUKA, YASUO MIYOSHI
Anticancer Research Oct 2022, 42 (10) 4867-4878; DOI: 10.21873/anticanres.15992

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Absolute Lymphocyte Count Is an Independent Prognostic Factor for ER-positive HER2-negative Advanced Breast Cancer Patients Treated With CDK4/6 Inhibitors
HARUKA KANAOKA, MASAYUKI NAGAHASHI, YUSA ATAKE, AKIRA HATTORI, AYAKO BUN, REIKO FUKUI, HIROMI OZAWA, YUKIE FUJIMOTO, TOMOKO HIGUCHI, KEIKO NATORI, MICHIKO IMAMURA, KEIKO MURASE, YUICHI TAKATSUKA, YASUO MIYOSHI
Anticancer Research Oct 2022, 42 (10) 4867-4878; DOI: 10.21873/anticanres.15992
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Keywords

  • Advanced breast cancer
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  • peripheral blood biomarker
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  • prognostic factor
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