Found 1 Presentation For Request " 32P"
32P - The neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios predict efficacy of CDK 4/6 inhibitors in women with hormone receptor-positive/HER2-negative advanced breast cancer
- Emma Zattarin (Milan, Italy)
- Emma Zattarin (Milan, Italy)
- Chiara Fabbroni (Milan, Italy)
- Francesca Ligorio (Milan, Italy)
- Federico Nichetti (Milan, Italy)
- Riccardo Lobefaro (Milan, Italy)
- Licia Rivoltini (Milan, Italy)
- Giuseppe Capri (Milan, Italy)
- Giulia V. Bianchi (Milan, Italy)
- Filippo Guglielmo Maria De Braud (Milan, Italy)
- Claudio Vernieri (Milan, Italy)
Abstract
Background
Preclinical evidence indicates that cyclin-dependent kinase (CDK) 4/6 inhibitors stimulate antitumor immunity, which may contribute to their anticancer activity. The neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) reflect systemic inflammation and immune system functional status, and could be associated with CDK 4/6 inhibitor efficacy in patients (pts) with hormone receptor-positive advanced breast cancer (HR+ aBC).
Methods
We performed a retrospective, monocentric study to investigate the association between NLR or PLR, as measured at baseline and after the first three treatment cycles, and progression free survival (PFS) in HR+ aBC pts treated with CDK 4/6 inhibitors in combination with endocrine therapies (ETs). The thresholds for NLR and PLR were defined using the maximally selected rank statistics. The impact of these parameters on PFS was evaluated at univariate and multivariable analysis by using Cox proportional hazard model.
Results
A total of 162 pts treated with palbociclib (n=142), ribociclib (n=16) or abemaciclib (n=3) plus ETs between January 2017 and December 2019 at our Institution were included. NLR and PLR at baseline were not associated with PFS. Conversely, high NLR (>3) and high PLR (>323.6) after three treatment cycles were associated with significantly lower PFS (p=0.011 and p=0.013, respectively). Multivariable analysis confirmed an independent association between high NLR or PLR and lower PFS (aHR 3.66, 95% CI 1.44-9.33, p=0.007 and aHR 2.79, 95% CI 1.36-5.70, p=0.005, respectively). Another factor associated with worse PFS was the presence of liver metastases (aHR 3.02, 95% CI 1.53-6.00, p=0.003).
Conclusions
This is the first study to show a significant association between high NLR or PLR values, as measured during CDK 4/6 inhibitor treatment, and lower PFS in HR+ aBC pts. Our results suggest that the NLR and PLR could be used as precocious biomarkers of treatment efficacy. A multicenter observational study to confirm these data in a larger cohort of pts is ongoing.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
G.V. Bianchi: Advisory/Consultancy: Novartis; Advisory/Consultancy: Eli Lilly. F.G.M. De Braud: Advisory/Consultancy: Roche; Advisory/Consultancy: EMD Serono; Advisory/Consultancy, principal investigator: Novartis; Advisory/Consultancy, principal investigator: Tesaro; Advisory/Consultancy, principal investigator: Loxo Oncology; Advisory/Consultancy, principal investigator: Celgene; Advisory/Consultancy, principal investigator: Nektar; Advisory/Consultancy, principal investigator: BMS. All other authors have declared no conflicts of interest.