Do Inflammatory Indices Have Prognostic Value in Metastatic Breast Cancer Patients Receiving CDK 4/6 Inhibitor Therapy?
Seray Saray1, Huseyin Kanmaz11Department of Medical Oncology, Balikesir Ataturk State Hospital, Balikesir, Türkey
Objectives: This study aims to elucidate the prognostic significance of biomarkers indicative of inflammation, including the platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), C-reactive protein-to-albumin ratio (CAR), and hemoglobin, albumin, lymphocyte, and platelet (HALP) scores, prior to treatment with CDK4/6 inhibitors in patients with hormone receptor-positive (HoR+)/HER2-negative (HER2-) advanced breast cancer. Methods: The study cohort comprised patients monitored at Balikesir Ataturk City Hospital, those with HoR+/HER2- metastatic breast cancer undergoing first-line CDK4/6 inhibitor therapy. PLR is defined as the platelet-to-lymphocyte ratio, NLR as the ratio of neutrophil count to lymphocyte count, CAR as the C-reactive protein-to-albumin ratio, and the HALP score is calculated as [hemoglobin (g/L) × albumin (g/L) × lymphocytes (/L)]/platelets (/L). Receiver operating characteristic (ROC) curve analysis was employed to determine the optimal cut-off values for these markers and to perform sensitivity-specificity calculations. Cox regression analysis was utilized for univariate survival risk analysis, and the Forward Stepwise (Likelihood Ratio) method was applied to the multivariate models. Results: A total of 38 patients with HR+/HER2? metastatic breast cancer were included. The median age was 59.5 years, and 78.9% were postmenopausal. Disease progression occurred in 55.2% of patients, and 7.8% died during follow-up. ROC analysis identified optimal prognostic cut-off values for PLR (128; AUC = 0.786, p=0.003) and HALP (32.6; AUC = 0.875, p=0.001), while NLR and CAR were not significant predictors. Median overall survival (OS) was 45 months, which was shorter in pre/perimenopausal patients and those with visceral metastases or elevated CAR (? 0.75). Multivariate analysis confirmed menopausal status, visceral metastasis, and high CAR as independent prognostic factors for OS Conclusion: The CAR index is a reliable, straightforward, readily accessible, and cost-efficient tool for predicting the prognosis of patients with metastasis. Keywords: Breast cancer, cdk 4/6 inhibitor, inflammatory indices
Cite This Article
Saray S, Kanmaz H. Do Inflammatory Indices Have Prognostic Value in Metastatic Breast Cancer Patients Receiving CDK 4/6 Inhibitor Therapy?. EJMI. 2025; 9(3): 113-119
Corresponding Author: Seray Saray