Significant Association Between Low Baseline Neutrophil-to-Lymphocyte Ratio and Improved Progression-free Survival of Patients With Locally Advanced or Metastatic Breast Cancer Treated With Eribulin But Not With Nab-Paclitaxel

Miyagawa, Yoshimasa; Araki, Kazuhiro; Bun, Ayako; Ozawa, Hiromi; Fujimoto, Yukie; Higuchi, Tomoko; Nishimukai, Arisa; Kira, Ayako; Imamura, Michiko; Takatsuka, Yuichi; Miyoshi, Yasuo

doi:10.1016/j.clbc.2018.03.002

Cited by 46 publications

(65 citation statements)

References 26 publications

(37 reference statements)

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“…In our opinion, the pretreatment NLR which was obtained within one week before any treatment was more representative of baseline immune status than posttreatment NLR which might be affected by chemotherapy and/or radiotherapy, even though NLR was calculated from blood data one month after last chemotherapy or radiotherapy. This was in line with most of studies that showed the low baseline NLR was associated with better survival outcomes [8,[19][20][21].…”

Section: Discussionsupporting

confidence: 90%

Roles of neutrophil/lymphocyte ratio in prognosis and in differentiation of potential beneficiaries in HER2-positive breast cancer with trastuzumab therapy

Ding

Huang

et al. 2019

Preprint

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Purpose: The relationship of neutrophil/lymphocyte ratio (NLR) with prognosis of HER2-positive breast cancer (BC) are not well studied. We aimed to assess the prognostic role of NLR in HER2-positive BC patients treated with or without trastuzumab.Methods: The clinical data of 843 HER2-positive BC patients from July 2013 to July 2018 were collected. The difference among variables was calculated by chi-square test. The associations between clinicopathological factors, NLR and disease-free survival (DFS) were analyzed by univariate and multivariate analyses.Results : Patients were divided into three groups. In group 1 containing 255 patients without trastuzumab treatment, pretreatment NLR showed no predictive value. Patients with trastuzumab treatment were divided into two groups on equal, according to pretreatment NLR values, low NLR (group 2) and high NLR (group 3). Patients in group 2 showed significantly higher 3-year DFS rate than patients in group 1 and group 3 (95.3% vs. 91.6% vs. 90.5%, respectively, P = 0.011); patients in the group 1 and group 3 had similar 3-year DFS outcome. Multivariate analysis showed high pretreatment NLR was significantly associated with shorter DFS (HR = 2.917, 95% CI=1.055-8.062, P = 0.039) in HER2-positive BC patients treated with trastuzumab. Conclusion : Among HER2-positive trastuzumab-treated BC patients, low pretreatment NLR value was associated with better DFS, and it might help to differentiate potential beneficiaries of trastuzumab treatment.

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Section: Discussionsupporting

confidence: 90%

Roles of neutrophil/lymphocyte ratio in prognosis and in differentiation of potential beneficiaries in HER2-positive breast cancer with trastuzumab therapy

Ding

Huang

et al. 2019

Preprint

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“…According to our scatter plot, ALC appeared to be useful in distinguishing patients with a favorable status, whereas NLR appeared to be useful in distinguishing those with an unfavorable status. Most studies prior to the present one determined their cutoff values on the basis of receiver-operating char- acteristic curves, the median value in their own cohorts, or cutoff values reported elsewhere [15,19,20]. As a result, cutoff values of 2.0-3.3 were commonly used for NLR, despite being almost average [16,17].…”

Section: Discussionmentioning

confidence: 99%

“…Several researchers have studied the absolute lymphocyte count (ALC) and neutrophil/lymphocyte ratio (NLR) with respect to their prognostic utility among patients undergoing chemotherapy for various types of cancer [10][11][12][13][14]. Accordingly, Miyagawa et al [15] found that baseline NLR was significantly associated with progression-free survival (PFS) among patients receiving eribulin for locally advanced or metastatic breast cancer, and these blood parameters are now expected as predictive markers for the efficacy of eribulin.…”

Section: Introductionmentioning

confidence: 99%

Utility of the Absolute Lymphocyte Count and Neutrophil/Lymphocyte Ratio for Predicting Survival in Patients with Metastatic Breast Cancer on Eribulin: A Real-World Observational Study

et al. 2019

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Introduction: Previous studies have suggested that the efficacy of eribulin is influenced by the activity of antitumor immunity of patients. Absolute lymphocyte count (ALC) and the neutrophil/lymphocyte ratio (NLR) are easily available parameters associated with the immunological status of patients. Objective: Here we tried to classify patients' immunological status by using the scatter plot of ALC and NLR, and investigated its utility for predicting survival among patients with metastatic breast cancer receiving eribulin. Methods: The medical records of 125 patients who received eribulin for metastatic breast cancer at our hospital between July 2011 and April 2019 were retrospectively reviewed. Uni-and multivariate analyses were performed to determine the association between baseline ALC/NLR and progression-free survival (PFS)/overall survival (OS). The cutoff values for ALC and NLR were determined using scatter plot analysis. Results: The entire cohort was classified into immunologically favorable (ALC ≥1,500/µL, 30 patients), intermediate (ALC < 1,500/µL, NLR < 5.0, 76 patients), and unfavorable (NLR ≥5.0, 19 patients) groups. Univariate analysis showed significant differences in PFS and OS between the groups, whereas multivariate analysis revealed that ALC ≥1,500/µL and NLR ≥5.0 were independent predictors of PFS, with adjusted hazard ratios (95% CI) of 0.57 (0.33-0.99) and 1.78 (1.00-3.15), respectively. NLR ≥5.0 was also associated with worse OS (adjusted hazard ratio: 0.55; 95% CI 0.35-0.88; p = 0.013). Conclusions: Among patients with metastatic breast cancer receiving eribulin, survival outcomes were well stratified according to baseline peripheral blood ALC and NLR. Accordingly, high ALC and NLR can be used as predictive markers for longer disease control and worse survival, respectively.

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“…We identified eight studies with data on NLR as a prognostic factor in patients with metastatic BC [54][55][56][57][58][59][60][61]. Four articles (50%) enrolled patients with all molecular subtypes [54,[56][57][58], two focused on patients with HER2-positive BC [55,61], one on patients with TNBC [60] and one on patients with hormone receptor-positive BC receiving hormone therapy as initial treatment [59] (Table 5).…”

Section: Patients With Advanced Breast Cancermentioning

confidence: 99%

Neutrophil to Lymphocyte Ratio as Prognostic and Predictive Factor in Breast Cancer Patients: A Systematic Review

Corbeau

Jacot

Guiu

2020

Cancers

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Inflammatory blood markers (IBM), such as the neutrophil to lymphocyte ratio (NLR), have emerged as potential prognostic factors in various cancers, including breast cancer (BC), potentially allowing an easy, minimally invasive evaluation of a given cancer‘s prognosis and treatment outcome. We report here a systematic overview of the published data evaluating NLR as a prognostic factor or predictive factor for pathological complete response (PCR) and toxicity in early and advanced BC. A total of 45 articles were identified. NLR was found to be an independent prognostic factor for survival in most of the adjuvant treatment studies. However, no significant correlation was found between survival and NLR for early BC patients receiving neo-adjuvant chemotherapy (NACT) and advanced BC patients. Most studies failed to find a significant correlation between NLR and PCR after NACT. Finally, some data showed that IBM could be predictive of chemotherapy-related toxicity.

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Significant Association Between Low Baseline Neutrophil-to-Lymphocyte Ratio and Improved Progression-free Survival of Patients With Locally Advanced or Metastatic Breast Cancer Treated With Eribulin But Not With Nab-Paclitaxel

Abstract: A low NLR at baseline was significantly associated with improved PFS in patients treated with eribulin but not in those treated with nab-paclitaxel. Therefore, the baseline NLR might be clinically useful for selecting patients who would benefit from eribulin.

Cited by 46 publications

References 26 publications

Roles of neutrophil/lymphocyte ratio in prognosis and in differentiation of potential beneficiaries in HER2-positive breast cancer with trastuzumab therapy

Roles of neutrophil/lymphocyte ratio in prognosis and in differentiation of potential beneficiaries in HER2-positive breast cancer with trastuzumab therapy

Utility of the Absolute Lymphocyte Count and Neutrophil/Lymphocyte Ratio for Predicting Survival in Patients with Metastatic Breast Cancer on Eribulin: A Real-World Observational Study

Neutrophil to Lymphocyte Ratio as Prognostic and Predictive Factor in Breast Cancer Patients: A Systematic Review

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