Predictive Role of Serum Inflammatory Markers in Metastatic Luminal A/B Breast Cancers Receiving CDK-4/6 Inhibitors Therapy.

BACKGROUND

We conducted this study to evaluate the impact of serum inflammatory markers and histopathological features on prognosis in metastatic hormone receptor positive breast cancer patients treated with first line CDK4/6i (cyclin-dependent kinase inhibitors).

OBJECTIVES

While serum markers are better indicators in triple-negative and HER-2 positive breast cancers, the PFS (progression-free survival) durations of NLR (neutrophil/lymphocyte ratio), PLR (platelet/lymphocyte ratio), and LMR (platelet/lymphocyte ratios) in luminal A-B group patients vary between studies. In our study investigated whether baseline NLR, PLR, and LMR have a predictive value for PFS in hormone-positive metastatic breast cancer receiving CDK4/6i.

MATERIAL AND

METHODS

The study included 111 patients with de novo metastasis or recurrence/metastasis after adjuvant/neo-adjuvant treatment who received CDK-4/6i as first-line therapy. NLR, PLR, LMR, lymphocyte, neutrophil, and monocyte values were recorded from peripheral blood analyses before CDK-4/6i treatment.

RESULTS

When the patient characteristics of patients were analyzed for progression-free survival, no statistically significant differences were found between age, ECOG, grade, Ki-67 index, and menopause status. PFS was not significantly associated with NLR, PLR, and LMR values (p = 0.87, p = 0.51, p = 0.22, respectively. In univariate analysis, among patients with LMR > 3.48, ribociclib was associated with longer PFS than palbociclib. Multivariate analysis revealed that the luminal B molecular subtype was associated with significantly worse PFS compared to luminal A (23 vs. 43 months, respectively, p = 0.01).

CONCLUSIONS

The prognostic impact of serum inflammatory markers in hormone receptor-positive metastatic breast cancer is heterogeneous. Although no statistical significance was observed in our cohort, high LMR levels may provide predictive and prognostic value in treatment selection.