Prognostic significance of systemic immune inflammation indices and prognostic nutritional index before CDK4/6 inhibitor therapy in hormone receptor positive, HER2 negative metastatic breast cancer patients

Abstract

Purpose: As systemic inflammatory indices and prognostic nutritional index are associated with poor prognosis in many tumor types, the goal of the present study was to ascertain their effect along with the neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, lymphocyte/monocyte ratio, C-reactive protein/albumin ratio, and systemic inflammatory response index on the progression-free survival (PFS) and overall survival (OS) of hormone receptor-positive HER2-negative (HR+/HER2−) metastatic breast cancer patients before CDK4/6 inhibitor treatment. Materials and methods: The medical records of 79 patients with HR+/HER2− metastatic breast cancer who presented at the Medical Oncology Outpatient Clinic between January 2018 and May 2022 were retrospectively analyzed to gather relevant data measured before CDK4/6 inhibitor treatment in order to establish the effect of key markers on their PFS and OS. Results: The median age of the participating patients, 70 (88.6%) of whom were postmenopausal, was 53 years (range 26-80 years). While 68 patients (86.1%) had a 0 performance score, 10 (12.7%) developed metastases during adjuvant endocrine therapy. Factors affecting PFS were age <50 (p=0.061), metastasis development during adjuvant endocrine therapy (p=0.09) and C-reactive protein/albumin ratio (p=0.019), while OS was primarily influenced by age <50 (p=0.069) and metastasis development during adjuvant endocrine therapy (p=0.012). Conclusion: In the examined HR+/HER2− metastatic breast cancer patients, systemic inflammatory indices and prognostic nutritional index before CDK4/6 inhibitor treatment affected PFS. In addition, metastasis development during adjuvant endocrine therapy, progesterone receptor percentage, and age below 50 years emerged as prognostic factors for shorter overall survival.