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Yamamoto M, Shibata M, Tanaka A, Tsunoda N, Masuda N. Identification of peripheral blood test parameters predicting the response to palbociclib and endocrine therapy for metastatic breast cancer: a retrospective study in a single institution. Surg Today 2024:10.1007/s00595-024-02893-z. [PMID: 38965074 DOI: 10.1007/s00595-024-02893-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 06/16/2024] [Indexed: 07/06/2024]
Abstract
PURPOSE Cyclin-dependent kinase 4/6 inhibitors have been used in endocrine therapy for patients with estrogen receptor (ER)-positive and human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer. Although randomized trials have shown that combined therapies prolong progression-free survival (PFS) in comparison to endocrine monotherapy, the predictors of efficacy are unknown. This study aimed to identify the blood test parameters to predict the effects of palbociclib and endocrine therapy. METHODS Seventy-nine patients treated with palbociclib and endocrine therapy between December 2017 and June 2022 were reviewed. We assessed PFS in patients according to factors evaluated based on patient characteristics and peripheral blood tests. RESULTS Patients in the C-reactive protein (CRP)-high, lactate dehydrogenase (LDH)-high, and albumin (Alb)-low groups had significantly shorter PFS than those in the normal group. A multivariate analysis revealed that high LDH and low Alb levels were independent factors that affected PFS. The Alb-low group had an inferior disease control rate. Patients in the CRP-high, LDH-high, and Alb-low groups who received these therapies as first- or second-line treatments showed poor PFS. CONCLUSIONS Several predictors of the efficacy of palbociclib and endocrine therapy were identified in the peripheral blood test parameters of patients with ER-positive and HER2-negative subtypes of metastatic breast cancer.
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Affiliation(s)
- Misato Yamamoto
- Department of Breast and Endocrine Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, Aichi, 466-8550, Japan
| | - Masahiro Shibata
- Department of Breast and Endocrine Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, Aichi, 466-8550, Japan.
- Depatment of Surgery, Nagoya Ekisaikai Hospital, 4-66 Shounen-Cho, Nakagawa-Ku, Nagoya, Aichi, 454-8502, Japan.
| | - Aya Tanaka
- Department of Breast and Endocrine Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, Aichi, 466-8550, Japan
- Department of Surgery, Inazawa Municipal Hospital, 100 Numa, Nazuka-Cho, Inazawa, Aichi, 492-8510, Japan
| | - Nobuyuki Tsunoda
- Department of Breast and Endocrine Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, Aichi, 466-8550, Japan
- Department of Surgery,, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, 3-35 Michishita-Cho, Nakamura-Ku, Nagoya, Aichi, 453-8511, Japan
| | - Norikazu Masuda
- Department of Breast and Endocrine Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, Aichi, 466-8550, Japan
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Nakamoto S, Shien T, Iwamoto T, Kubo S, Yamamoto M, Yamashita T, Kuwahara C, Ikeda M. Absolute lymphocyte count and neutrophil-to-lymphocyte ratio as predictors of CDK 4/6 inhibitor efficacy in advanced breast cancer. Sci Rep 2024; 14:9869. [PMID: 38684839 PMCID: PMC11059159 DOI: 10.1038/s41598-024-60101-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 04/18/2024] [Indexed: 05/02/2024] Open
Abstract
Cyclin-dependent kinase 4 and 6 inhibitors (CDK4/6i) are the standard agents for treating patients with estrogen receptor-positive and human epidermal growth factor receptor 2-negative advanced breast cancer (ER + HER2 - ABC). However, markers predicting the outcomes of CDK4/6i treatment have yet to be identified. This study was a single-center retrospective cohort study. We retrospectively evaluated 101 patients with ER + HER2 - ABC receiving CDK4/6i in combination with endocrine therapy at Fukuyama City Hospital between November 2017 and July 2021. We investigated the clinical outcomes and the safety of CDK4/6i treatment, and the absolute lymphocyte count (ALC) and neutrophil-to-lymphocyte ratio (NLR) as predictive markers for CDK4/6i. We defined the cut-off values as 1000/μL for ALC and 3 for NLR, and divided into "low" and "high" groups, respectively. We evaluated 43 and 58 patients who received abemaciclib and palbociclib, respectively. Patients with high ALC and low NLR had significantly longer overall survival than those with low ALC and high NLR (high vs. low; ALC: HR 0.29; 95% CI 0.12-0.70; NLR: HR 2.94; 95% CI 1.21-7.13). There was no significant difference in efficacy between abemaciclib and palbociclib and both had good safety profiles. We demonstrated that ALC and NLR might predict the outcomes of CDK4/6i treatment in patients with ER + HER2 - ABC.
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Affiliation(s)
- Shogo Nakamoto
- Department of Breast and Thyroid Surgery, Fukuyama City Hospital, 5-23-1 Zao, Fukuyama, 721-8511, Japan.
- Department of Breast and Endocrine Surgery, Okayama University Hospital, 2-5-1, Shikata-Cho, Kita-Ku, Okayama, 700-8558, Japan.
| | - Tadahiko Shien
- Department of Breast and Endocrine Surgery, Okayama University Hospital, 2-5-1, Shikata-Cho, Kita-Ku, Okayama, 700-8558, Japan
| | - Takayuki Iwamoto
- Department of Breast and Endocrine Surgery, Okayama University Hospital, 2-5-1, Shikata-Cho, Kita-Ku, Okayama, 700-8558, Japan
| | - Shinichiro Kubo
- Department of Breast and Thyroid Surgery, Fukuyama City Hospital, 5-23-1 Zao, Fukuyama, 721-8511, Japan
| | - Mari Yamamoto
- Department of Breast and Thyroid Surgery, Fukuyama City Hospital, 5-23-1 Zao, Fukuyama, 721-8511, Japan
| | - Tetsumasa Yamashita
- Department of Breast and Thyroid Surgery, Fukuyama City Hospital, 5-23-1 Zao, Fukuyama, 721-8511, Japan
| | - Chihiro Kuwahara
- Department of Breast and Thyroid Surgery, Fukuyama City Hospital, 5-23-1 Zao, Fukuyama, 721-8511, Japan
| | - Masahiko Ikeda
- Department of Breast and Thyroid Surgery, Fukuyama City Hospital, 5-23-1 Zao, Fukuyama, 721-8511, Japan
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Wickmann A, Kurte MS, Jeck J, Camacho L, Klinkhammer D, Kron F, Dengler R. Cost-benefit evaluation of advanced therapy lines in metastatic triple-negative breast cancer in Germany. COST EFFECTIVENESS AND RESOURCE ALLOCATION 2024; 22:21. [PMID: 38459569 PMCID: PMC10924420 DOI: 10.1186/s12962-024-00528-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 03/01/2024] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND Triple-negative breast cancer (TNBC) is responsible for 10-20% cases of breast cancer and is resulting in rising healthcare costs. Thus, health-economic evaluations are needed to relate clinical outcomes and costs of treatment options and to provide recommendations of action from a health-economic perspective. METHODS We investigated the cost-benefit-ratio of approved treatment options in metastatic TNBC in Germany by applying the efficiency frontier approach. These included sacituzumab-govitecan (SG), eribulin, vinorelbine, and capecitabine. Clinical benefit was measured as (i) median overall survival (mOS) and (ii) health-related quality of life (HRQoL) in terms of time to symptom worsening (TSW). To assess medical benefits, literature was systematically reviewed in PubMed for (i) and (ii), respectively. Treatment costs were calculated considering annual direct outpatient treatment costs from a statutory healthcare payer perspective. It was intended that both, (i) and (ii), yield an efficiency frontier. RESULTS Annual direct outpatient treatment costs amounted to EUR 176,415.21 (SG), EUR 47,414.14 (eribulin), EUR 13,711.35 (vinorelbine), and EUR 3,718.84 (capecitabine). Systematic literature review of (i) and statistical analysis resulted in OS values of 14.3, 9.56, 9.44, and 7.46 months, respectively. Capecitabine, vinorelbine, and SG are part of the efficiency frontier including OS. The highest additional benefit per additional cost was determined for vinorelbine, followed by SG. Systematic review of (ii) revealed that no TSW data of TNBC patients receiving vinorelbine were available, preventing the presentation of an efficiency frontier including HRQoL. CONCLUSIONS Vinorelbine is most cost-effective, followed by SG. Health-economic evaluations support decision-makers to assess treatment options within one indication area. In Germany, the efficiency frontier can provide decision support for the pricing of innovative interventions. Results of our analysis may thus guide reimbursement determination.
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Affiliation(s)
| | - Melina Sophie Kurte
- VITIS Healthcare Group, Cologne, Germany
- Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Julia Jeck
- Faculty of Medicine, Department I of Internal Medicine, University of Cologne, University Hospital Cologne, Cologne, Germany
| | | | | | - Florian Kron
- VITIS Healthcare Group, Cologne, Germany
- Faculty of Medicine, Department I of Internal Medicine, University of Cologne, University Hospital Cologne, Cologne, Germany
- Faculty of Medicine, Center for Integrated Oncology (CIO ABCD), University of Cologne, University Hospital Cologne, Cologne, Germany
- FOM University of Applied Sciences, Essen, Germany
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Tokunaga E, Miyoshi Y, Dozono K, Kawaguchi T, Toi M. Association of Neutrophil-to-Lymphocyte Ratio and Absolute Lymphocyte Count With Clinical Outcomes in Advanced Breast Cancer in the MONARCH 2 Trial. Oncologist 2024; 29:e319-e329. [PMID: 37971418 PMCID: PMC10911923 DOI: 10.1093/oncolo/oyad301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 10/25/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Established prognostic factors for treatment response to cyclin-dependent kinases 4 and 6 inhibitors are currently lacking. We aimed to investigate the relationship of pretreatment neutrophil-to-lymphocyte ratio (NLR) and absolute lymphocyte count (ALC) to abemaciclib outcomes. PATIENTS AND METHODS This was a post hoc analysis of data from MONARCH 2, a phase III study of abemaciclib or placebo plus fulvestrant in hormone-receptor positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) advanced breast cancer that progressed on endocrine therapy. Patients were divided into high and low categories based on baseline NLR (cutoff: 2.5) and ALC (cutoff: 1.5 × 109/L). The association of baseline NLR and ALC with progression-free survival (PFS) and overall survival (OS) was explored using Cox models and Kaplan-Meier estimates. Tumor response and safety were also examined. RESULTS NLR and ALC data were available for 645 patients (abemaciclib: N = 426; placebo: N = 219). Low-baseline NLR or high-baseline ALC was consistently associated with positive PFS and OS trends; low-baseline NLR subgroups also showed trends for better response. The abemaciclib treatment effect against placebo was observed regardless of baseline NLR or ALC. Univariate analyses showed baseline NLR and ALC were prognostic of PFS and OS. Baseline NLR remained significant in the multivariate model (P < .0001). No unexpected differences in safety were observed by baseline NLR or ALC. CONCLUSION Baseline NLR was independently prognostic of PFS and OS. Low-baseline NLR was associated with numerically better efficacy outcomes, but the benefit of adding abemaciclib to fulvestrant was similar irrespective of baseline NLR status.
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Affiliation(s)
- Eriko Tokunaga
- Department of Breast Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Yasuo Miyoshi
- Department of Surgery, Division of Breast and Endocrine Surgery, Hyogo College of Medicine, Hyogo, Japan
| | - Koji Dozono
- Japan Drug Development and Medical Affairs, Eli Lilly Japan K.K., Kobe, Japan
| | - Tsutomu Kawaguchi
- Japan Drug Development and Medical Affairs, Eli Lilly Japan K.K., Kobe, Japan
| | - Masakazu Toi
- Director, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
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Su MX, Lin HW, Nguyen HTH, Lin TC, Chen CJ, Wang HC, Wu CT, Wu YC, He GY, Liu LC, Huang CH. Monitoring trends in the absolute lymphocyte count and the neutrophil-to-lymphocyte ratio in patients with breast cancer receiving eribulin. BMC Cancer 2024; 24:195. [PMID: 38347468 PMCID: PMC10860250 DOI: 10.1186/s12885-024-11923-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 01/26/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Studies have shown that the absolute lymphocyte count (ALC) and the neutrophil-to-lymphocyte ratio (NLR) are related to the outcomes in patients with breast cancer receiving specific chemotherapies. However, the reports have focussed on the initial blood test and there is a lack of evidence or data to support that dynamic changes of ALC or NLR are associated with the patients' survival outcomes. METHODS We retrospectively reviewed electronic medical records from patients with breast cancer treated with eribulin from 2015 to 2019 at our institution. Blood test data were available prior to starting eribulin (baseline), and at 1, 3 and 6 months after initiating eribulin. We classified the patients into ALC and NLR high and low groups using the following cut-offs: 1000/µl for ALC and 3 for NLR. We defined ALC and NLR trends as increasing or decreasing compared with the initial data. We assessed the associations between the ALC and NLR with progression-free survival and overall survival. RESULTS There were 136 patients with breast cancer treated with eribulin. Of these patients, 60 had complete blood tests and follow-up data. Neither a high ALC nor a low baseline NLR was associated with the survival outcome. One month after initiating eribulin treatment, a high ALC and a low NLR were significantly associated with longer progression-free survival (p = 0.044 for each). Three months after initiating eribulin, a high ALC was significantly associated with better overall survival (p = 0.006). A high NLR at 3 or 6 months after initiating eribulin was associated with worse overall survival (p = 0.017 and p = 0.001, respectively). The ALC and NLR trends across times were not associated with survivals. CONCLUSION We showed that 1, 3 and 6 months after initiating eribulin, a high ALC and a low NLR may be related to the patients' survival outcomes. The ALC and NLR trends were not associated with survival. Accordingly, we believe patients who maintain a high ALC and a low NLR may have better clinical outcomes after initiating eribulin.
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Affiliation(s)
- Meng-Xia Su
- Surgical Department, China Medical University Hospital, No. 2, Yude Rd. North Dist, Taichung, 404327, Taiwan
| | - Hsiang-Wen Lin
- School of Pharmacy and Graduate Institute, China Medical University, No. 100, Sec. 1, Jingmao Rd., Taichung, 406040, Taiwan
- Department of Pharmacy, China Medical University Hospital, No. 2, Yude Rd., North Dist., Taichung, 404327, Taiwan
- Department of Pharmacy System, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago, Chicago, 833 S. Wood St., Chicago, 60612, Illinois, United States of America
| | - Hanh T H Nguyen
- School of Pharmacy and Graduate Institute, China Medical University, No. 100, Sec. 1, Jingmao Rd., Taichung, 406040, Taiwan
- Department of Clinical Pharmacy, Hanoi University of Pharmacy, No. 144, Xuan Thuy, Cau giay, Hanoi, Vietnam
| | - Tien-Chao Lin
- School of Pharmacy and Graduate Institute, China Medical University, No. 100, Sec. 1, Jingmao Rd., Taichung, 406040, Taiwan
- Department of Pharmacy, China Medical University Hospital, No. 2, Yude Rd., North Dist., Taichung, 404327, Taiwan
| | - Chih-Jung Chen
- Surgical Department, China Medical University Hospital, No. 2, Yude Rd. North Dist, Taichung, 404327, Taiwan
| | - Hwei-Chung Wang
- Surgical Department, China Medical University Hospital, No. 2, Yude Rd. North Dist, Taichung, 404327, Taiwan
| | - Chen-Teng Wu
- Surgical Department, China Medical University Hospital, No. 2, Yude Rd. North Dist, Taichung, 404327, Taiwan
| | - Yao-Chung Wu
- Surgical Department, China Medical University Hospital, No. 2, Yude Rd. North Dist, Taichung, 404327, Taiwan
| | - Geng-Yan He
- Surgical Department, China Medical University Hospital, No. 2, Yude Rd. North Dist, Taichung, 404327, Taiwan
| | - Liang-Chih Liu
- Surgical Department, China Medical University Hospital, No. 2, Yude Rd. North Dist, Taichung, 404327, Taiwan.
- College of Medicine, China Medical University, No. 100, Sec. 1, Jingmao Rd., Taichung, 406040, Taiwan.
| | - Chih-Hao Huang
- Surgical Department, China Medical University Hospital, No. 2, Yude Rd. North Dist, Taichung, 404327, Taiwan.
- College of Medicine, China Medical University, No. 100, Sec. 1, Jingmao Rd., Taichung, 406040, Taiwan.
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Shimada H, Fujimoto A, Matsuura K, Kohyama S, Nukui A, Ichinose Y, Asano A, Ohara M, Ishiguro H, Osaki A, Saeki T. Comprehensive prognostic prediction of metastatic breast cancer treated with eribulin using blood‑based parameters and ratio. Mol Clin Oncol 2024; 20:15. [PMID: 38274088 PMCID: PMC10809355 DOI: 10.3892/mco.2024.2713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 11/13/2023] [Indexed: 01/27/2024] Open
Abstract
Eribulin is widely used to treat metastatic breast cancer (BC). Higher neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are associated with higher mortality in several cancer types. However, the association between BC prognosis and peripheral immune status remains controversial. In the present study, the relative effects of NLR and PLR on survival in patients with metastatic BC were quantified and their clinical prognostic value was evaluated. This retrospective study included 156 patients with metastatic BC who received eribulin monotherapy at Saitama Medical University International Medical Center. Clinicopathological features were examined (peripheral blood findings and biochemical liver and kidney function test results) and univariate and multivariate analyses were conducted of the overall survival (OS). The 156 patients treated with eribulin had a median follow-up duration of 18.3 months. Before eribulin treatment, patients with absolute lymphocyte counts (ALC) >1,500/µl, NLR <3.0, and PLR <150 had significantly longer OS than those with lower ALC, and higher NLR and PLR (median OS, 25.5 vs. 15.5 months; P<0.01; 20.3 vs. 13.6 months, P<0.01; and 29.2 vs. 14.8 months; P<0.001, respectively). Patients with anemia [hemoglobin (Hb) <10 g/dl] or liver dysfunction [albumin-bilirubin (ALBI) grade 2/3] had significantly shorter OS than those without (P<0.001, respectively). Multivariate analysis revealed low ALBI grade (P<0.001), high Hb (P<0.01) and low PLR (P<0.05) as independent factors of longer OS after eribulin administration. Low PLR, anemia and liver dysfunction might be factors associated with prolonged OS in patients with metastatic BC on eribulin therapy, which could be clinically useful, as their evaluation requires neither new equipment nor invasive testing.
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Affiliation(s)
- Hiroko Shimada
- Department of Breast Oncology, Saitama Medical University International Medical Center, Hidaka, Saitama 350-1298, Japan
| | - Akihiro Fujimoto
- Department of Breast Oncology, Saitama Medical University International Medical Center, Hidaka, Saitama 350-1298, Japan
| | - Kazuo Matsuura
- Department of Breast Oncology, Saitama Medical University International Medical Center, Hidaka, Saitama 350-1298, Japan
| | - Shunsuke Kohyama
- Department of Pharmacy, Saitama Medical University International Medical Center, Hidaka, Saitama 350-1298, Japan
| | - Asami Nukui
- Department of Breast Oncology, Saitama Medical University International Medical Center, Hidaka, Saitama 350-1298, Japan
| | - Yuki Ichinose
- Department of Breast Oncology, Saitama Medical University International Medical Center, Hidaka, Saitama 350-1298, Japan
| | - Aya Asano
- Department of Breast Oncology, Saitama Medical University Hospital, Moroyama-machi, Saitama 350-0495, Japan
| | - Masahiro Ohara
- Department of Breast Oncology, Saitama Medical University International Medical Center, Hidaka, Saitama 350-1298, Japan
| | - Hiroshi Ishiguro
- Department of Breast Oncology, Saitama Medical University International Medical Center, Hidaka, Saitama 350-1298, Japan
| | - Akihiko Osaki
- Department of Breast Oncology, Saitama Medical University International Medical Center, Hidaka, Saitama 350-1298, Japan
| | - Toshiaki Saeki
- Department of Breast Oncology, Saitama Medical University International Medical Center, Hidaka, Saitama 350-1298, Japan
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Shimizu T, Oba T, Oshi M, Ito KI. Eribulin promotes proliferation of CD8 + T cells and potentiates T cell-mediated anti-tumor activity against triple-negative breast cancer cells. Breast Cancer Res Treat 2024; 203:57-71. [PMID: 37733186 DOI: 10.1007/s10549-023-07111-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 08/24/2023] [Indexed: 09/22/2023]
Abstract
PURPOSE Chemotherapeutic agents exert immunomodulatory effects on triple-negative breast cancer (TNBC) cells and immune cells. Eribulin favorably affects the immunological status of patients with breast cancer. However, the effects of eribulin on the immune cells remain unexplored. The aim of this study was to investigate the effects of eribulin on immune cells. METHODS Peripheral blood mononuclear cells (PBMCs) from healthy donors and mouse splenocytes were stimulated with anti-CD3 and anti-CD28 antibodies. The effects of eribulin and paclitaxel on cell proliferation and differentiation status were analyzed using flow cytometry. RNA sequencing was performed to assess alterations in gene expression in CD8+ T cells following eribulin and paclitaxel treatment. Using TNBC cell lines (MDA-MB-231, Hs578T, and MDA-MB-157), the anti-tumor activity of CD3/CD28-stimulated T cells combined with eribulin or paclitaxel was evaluated. RESULTS Eribulin did not affect CD3/CD28-stimulated PBMCs proliferation. However, eribulin significantly decreased the CD4/CD8 ratio in T cells, indicating that eribulin facilitates CD8+ T cell proliferation. Furthermore, eribulin significantly increased the frequency of less differentiated CD45RA+, CCR7+, and TCF1+ subsets of CD8+ T cells. RNA sequencing revealed that eribulin enhanced the expression of gene sets related to cell proliferation and immune responses. Moreover, eribulin augmented the anti-tumor effects of CD3/CD28-stimulated T cells against TNBC cells. These results were not observed in experiments using paclitaxel. CONCLUSIONS Eribulin promoted CD8+ T cell proliferation, repressed effector T cell differentiation, and harnessed T cell-mediated anti-tumor effects. These mechanisms may be one of the cues that eribulin can improve the immunological status of tumor-bearing hosts.
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Affiliation(s)
- Tadafumi Shimizu
- Division of Breast and Endocrine Surgery, Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-861, Japan
| | - Takaaki Oba
- Division of Breast and Endocrine Surgery, Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-861, Japan.
| | - Masanori Oshi
- Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Ken-Ichi Ito
- Division of Breast and Endocrine Surgery, Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-861, Japan
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Moukas SI, Kasimir-Bauer S, Tewes M, Kolberg HC, Hoffmann O, Kimmig R, Keup C. Ratios of monocytes and neutrophils to lymphocytes in the blood predict benefit of CDK4/6 inhibitor treatment in metastatic breast cancer. Sci Rep 2023; 13:21262. [PMID: 38040730 PMCID: PMC10692150 DOI: 10.1038/s41598-023-47874-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 11/19/2023] [Indexed: 12/03/2023] Open
Abstract
Biomarkers to identify metastatic breast cancer (mBC) patients resistant to CDK4/6 inhibition (CDK4/6i) are currently missing. We evaluated the usefulness of the monocyte-to-lymphocyte ratio (MLR), the neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) as predictive markers for de novo resistance to CDK4/6i. Various blood cell counts and MLR, NLR, PLR were recorded before treatment initiation (baseline) and four weeks later from 97 mBC patients receiving endocrine therapy (ET) alone or in combination with CDK4/6i. Binary blood cell count/ratios (mean = cut-off) were related to outcome using Cox regression. High MLR (p = 0.001) and high NLR (p = 0.01) at baseline significantly correlated with a shorter progression-free survival (PFS) in the CDK4/6i cohort, independent of any other clinical parameter as determined by multivariate Cox regression. Both, high MLR (p = 0.008) and high NLR (p = 0.043) as well as a decrease in PLR after four weeks of CDK4/6i first line treatment (p = 0.01) indicated a shorter overall survival. Moreover, decreasing PLR (p = 0.043) and increasing mean corpuscular volume (MCV; p = 0.011) within the first cycle of CDK4/6i correlated with a shorter PFS and decreasing MLR (p = 0.039) within the first cycle of first-line CDK4/6i was also correlated with shorter PFS. In summary, easily assessable blood cell parameter were shown to have predictive, monitoring and prognostic value and thus, could, in future, be used for individualized CDK4/6i therapy management. Most importantly, the imbalance of NLR and MLR at baseline might serve as predictive marker for de novo resistance to CDK4/6i in mBC patients.
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Affiliation(s)
- Stefanos Ioannis Moukas
- Department of Gynecology and Obstetrics, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany.
| | - Sabine Kasimir-Bauer
- Department of Gynecology and Obstetrics, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany
| | - Mitra Tewes
- Department of Medical Oncology, University Hospital Essen, 45147, Essen, Germany
- Department of Palliative Medicine, West German Cancer Center, University Hospital Essen, 45147, Essen, Germany
| | - Hans-Christian Kolberg
- Department of Gynecology and Obstetrics, Marienhospital Bottrop, 46236, Bottrop, Germany
| | - Oliver Hoffmann
- Department of Gynecology and Obstetrics, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany
| | - Rainer Kimmig
- Department of Gynecology and Obstetrics, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany
| | - Corinna Keup
- Department of Gynecology and Obstetrics, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany
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Bun A, Nagahashi M, Kuroiwa M, Komatsu M, Miyoshi Y. Baseline interleukin-6 is a prognostic factor for patients with metastatic breast cancer treated with eribulin. Breast Cancer Res Treat 2023; 202:575-583. [PMID: 37733188 PMCID: PMC10564839 DOI: 10.1007/s10549-023-07086-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 08/10/2023] [Indexed: 09/22/2023]
Abstract
PURPOSE Eribulin is a unique anti-cancer drug which can improve overall survival (OS) of patients with metastatic breast cancer (MBC), probably by modulating the tumor immune microenvironment. The aim of this study was to investigate the clinical significance of serum levels of immune-related and inflammatory cytokines in patients treated with eribulin. Furthermore, we investigated the association between cytokines and immune cells, such as myeloid-derived suppressor cells (MDSCs) and cytotoxic and regulatory T cells, to explore how these cytokines might affect the immune microenvironment. METHODS Sixty-eight patients with MBC treated with eribulin were recruited for this retrospective study. The relationship of cytokines, including interleukin (IL)-6, to progression-free survival and OS was examined. CD4+ and CD8+ lymphocyte, MDSCs and regulatory T cell levels were determined in the blood by flow cytometry analysis. RESULTS In our cohort, patients with high IL-6 at baseline had shorter progression-free survival and OS compared with those with low IL-6 (p = 0.0017 and p = 0.0012, respectively). Univariable and multivariable analyses revealed that baseline IL-6 was an independent prognostic factor for OS (p = 0.0058). Importantly, CD8+ lymphocytes were significantly lower and MDSCs were significantly higher in patients with high IL-6, compared to those with low IL-6. CONCLUSION Baseline IL-6 is an important prognostic factor in patients with MBC treated with eribulin. Our results show that high IL-6 is associated with higher levels of MDSCs which suppress anti-tumor immunity, such as CD8+ cells. It appears that eribulin is not particularly effective in patients with high IL-6 due to a poor tumor immune microenvironment.
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Affiliation(s)
- Ayako Bun
- Department of Surgery, Division of Breast and Endocrine Surgery, School of Medicine, Hyogo Medical University, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
| | - Masayuki Nagahashi
- Department of Surgery, Division of Breast and Endocrine Surgery, School of Medicine, Hyogo Medical University, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
| | - Mamiko Kuroiwa
- Department of Surgery, Division of Breast and Endocrine Surgery, School of Medicine, Hyogo Medical University, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
| | - Miki Komatsu
- Department of Surgery, Division of Breast and Endocrine Surgery, School of Medicine, Hyogo Medical University, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
| | - Yasuo Miyoshi
- Department of Surgery, Division of Breast and Endocrine Surgery, School of Medicine, Hyogo Medical University, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan.
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10
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Nakamoto S, Shien T, Itoh M, Yamamoto Y, Ohsumi S, Yoshitomi S, Hikino H, Miyoshi K, Notsu A, Taira N, Doihara H, Ikeda M. Systemic immunity markers are associated with clinical outcomes of atezolizumab treatment in patients with triple-negative advanced breast cancer: a retrospective multicenter observational study. Clin Exp Med 2023; 23:5129-5138. [PMID: 37904008 DOI: 10.1007/s10238-023-01230-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 10/19/2023] [Indexed: 11/01/2023]
Abstract
Immune checkpoint inhibitors (ICI) are reportedly efficacious against triple-negative breast cancer (TNBC) and are now recommended as first-line therapy. Systemic immunity markers, the absolute lymphocyte count (ALC) and the neutrophil-to-lymphocyte ratio (NLR), have been identified as predict ICI efficacy in patients with various cancers. We retrospectively enrolled 36 TNBC patients who received atezolizumab treatment between September 2019 and May 2021 at eight Japanese medical institutions. We evaluated systemic immunity markers, including dynamic changes in these markers, as predictors of survival benefit derived from atezolizumab treatment. Median time-to-treatment failure (TTF) and overall survival (OS) were 116 days and "not reached", respectively. Patients with low NLR at baseline and decreased NLR at the start of the second cycle (SO2nd) had significantly longer OS than those with high NLR at baseline and increased NLR (SO2nd) (log-rank P < 0.001 and log-rank P = 0.049, respectively). Multivariate analyses identified high ALC at baseline and decreased NLR (SO2nd) as independent predictive markers for longer TTF (P = 0.043 and P = 0.002, respectively), and low NLR at baseline and decreased NLR (SO2nd) as independent predictive markers for longer OS (P < 0.001 and P = 0.013, respectively). The safety profile was consistent with those of previous trials. This retrospective multicenter observational study showed the clinical efficacy and safety of atezolizumab treatment. Furthermore, systemic immunity markers, including their dynamic changes, were found to be associated with clinical outcomes of atezolizumab treatment in patients with advanced or metastatic TNBC.
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Affiliation(s)
- Shogo Nakamoto
- Department of Breast and Endocrine Surgery, Okayama University Hospital, 2-5-1, Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.
| | - Tadahiko Shien
- Department of Breast and Endocrine Surgery, Okayama University Hospital, 2-5-1, Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Mitsuya Itoh
- Department of Breast Surgery, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Yutaka Yamamoto
- Department of Breast and Thyroid Surgery, Kawasaki Medical School Hospital, Kurashiki, Japan
| | - Shozo Ohsumi
- Department of Breast Oncology, NHO Shikoku Cancer Center, Matsuyama, Japan
| | - Seiji Yoshitomi
- Department of Breast and Endocrine Surgery, Red Cross Okayama Hospital, Okayama, Japan
| | - Hajime Hikino
- Department of Breast Surgery, Matsue Red Cross Hospital, Matsue, Japan
| | - Kazuya Miyoshi
- Department of Breast and Endocrine Surgery, National Hospital Organization Fukuyama Medical Center, Fukuyama, Japan
| | - Akifumi Notsu
- Clinical Research Center, Shizuoka Cancer Center, Nagaizumi-cho, Japan
| | - Naruto Taira
- Department of Breast and Endocrine Surgery, Okayama University Hospital, 2-5-1, Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
- Department of Breast and Thyroid Surgery, Kawasaki Medical School Hospital, Kurashiki, Japan
| | - Hiroyoshi Doihara
- Department of Breast and Endocrine Surgery, Okayama University Hospital, 2-5-1, Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
- Department of Surgery, Kawasaki Medical School General Medical Center, Okayama, Japan
| | - Masahiko Ikeda
- Department of Breast and Thyroid Surgery, Fukuyama Citizens Hospital, Fukuyama, Japan
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11
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Wada A, Hirohashi Y, Kutomi G, Murata K, Iwabuchi S, Mizue Y, Murai A, Kyuno D, Shima H, Minowa T, Sasaki K, Kubo T, Kanaseki T, Tsukahara T, Nakatsugawa M, Hashimoto S, Osanai M, Torigoe T, Takemasa I. Eribulin is an immune potentiator in breast cancer that upregulates human leukocyte antigen class I expression via the induction of NOD-like receptor family CARD domain-containing 5. Cancer Sci 2023; 114:4511-4520. [PMID: 37991442 PMCID: PMC10728009 DOI: 10.1111/cas.15986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 09/10/2023] [Accepted: 09/18/2023] [Indexed: 11/23/2023] Open
Abstract
Eribulin inhibits microtubule polymerization and improves the overall survival of patients with recurrent metastatic breast cancer. A subgroup analysis revealed a low neutrophil to lymphocyte ratio (NLR) (<3) to be a prognostic factor of eribulin treatment. We thus hypothesized that eribulin might be related to the immune response for breast cancer cells and we analyzed the effects of eribulin on the immune system. Immunohistochemical staining revealed that human leukocyte antigen (HLA) class I expression was increased in clinical samples after eribulin treatment. In vitro assays revealed that eribulin treatment increased HLA class I expression in breast cancer line cells. RNA-sequencing demonstrated that eribulin treatment increased the expression of the NOD-like family CARD domain-containing 5 (NLRC5), a master regulator of HLA class I expression. Eribulin treatment increased the NY-ESO-1-specific T-cell receptor (TCR) transduced T (TCR-T) cell response for New York oesophageal squamous cell carcinoma 1 (NY-ESO-1) overexpressed breast cancer cells. The eribulin and TCR-T combined therapy model revealed that eribulin and immunotherapy using TCR-T cells has a synergistic effect. In summary, eribulin increases the expression of HLA class 1 via HLA class 1 transactivatior NLRC5 and eribulin combination with immunotherapy can be effective for the treatment of breast cancer.
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Affiliation(s)
- Asaka Wada
- Department of PathologySapporo Medical University School of MedicineSapporoJapan
- Department of SurgerySapporo Medical University School of MedicineSapporoJapan
| | - Yoshihiko Hirohashi
- Department of PathologySapporo Medical University School of MedicineSapporoJapan
| | - Goro Kutomi
- Department of SurgerySapporo Medical University School of MedicineSapporoJapan
| | - Kenji Murata
- Department of PathologySapporo Medical University School of MedicineSapporoJapan
| | - Sadahiro Iwabuchi
- Department of Molecular PathophysiologyInstitute of Advanced Medicine, Wakayama Medical UniversityWakayamaJapan
| | - Yuka Mizue
- Department of PathologySapporo Medical University School of MedicineSapporoJapan
| | - Aiko Murai
- Department of PathologySapporo Medical University School of MedicineSapporoJapan
| | - Daisuke Kyuno
- Department of PathologySapporo Medical University School of MedicineSapporoJapan
- Department of SurgerySapporo Medical University School of MedicineSapporoJapan
| | - Hiroaki Shima
- Department of SurgerySapporo Medical University School of MedicineSapporoJapan
| | - Tomoyuki Minowa
- Department of PathologySapporo Medical University School of MedicineSapporoJapan
| | - Kenta Sasaki
- Department of PathologySapporo Medical University School of MedicineSapporoJapan
| | - Terufumi Kubo
- Department of PathologySapporo Medical University School of MedicineSapporoJapan
| | - Takayuki Kanaseki
- Department of PathologySapporo Medical University School of MedicineSapporoJapan
| | - Tomohide Tsukahara
- Department of PathologySapporo Medical University School of MedicineSapporoJapan
| | - Munehide Nakatsugawa
- Department of PathologyTokyo Medical University Hachioji Medical CenterTokyoJapan
| | - Shinichi Hashimoto
- Department of Molecular PathophysiologyInstitute of Advanced Medicine, Wakayama Medical UniversityWakayamaJapan
| | - Makoto Osanai
- Department of PathologySapporo Medical University School of MedicineSapporoJapan
| | - Toshihiko Torigoe
- Department of PathologySapporo Medical University School of MedicineSapporoJapan
| | - Ichiro Takemasa
- Department of SurgerySapporo Medical University School of MedicineSapporoJapan
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12
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Matsuura M, Yorozu K, Nagao S, Kurokawa S, Tamate M, Akimoto T, Saito T. Therapeutic efficacy of a four-year treatment with eribulin in a patient with uterine leiomyosarcoma: A case report. Gynecol Oncol Rep 2023; 47:101205. [PMID: 37273765 PMCID: PMC10238571 DOI: 10.1016/j.gore.2023.101205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 05/10/2023] [Accepted: 05/17/2023] [Indexed: 06/06/2023] Open
Abstract
Uterine leiomyosarcoma (LMS) is a gynecological malignancy with an extremely poor prognosis. Multiple new therapeutic agents, including pazopanib, trabectedin, and eribulin, have been clinically applied to treat uterine LMS, and their therapeutic effects are expected. We encountered one patient with advanced recurrent uterine LMS who achieved a partial response to a four-year treatment with eribulin. A 31-year-old woman was diagnosed with stage 2B LMS. After the first recurrence, Gemcitabine, Docetaxel (GD) therapy was administered, and complete response (CR) was achieved. However, 2 years and 10 months later, recurrence occurred at the vaginal cuff, and GD therapy and doxorubicin hydrochloride were administered, resulting in CR. Five months later, she experienced another recurrence at the same location and was treated with eribulin. To date, 53 courses of eribulin have been administered and are currently ongoing. Maintaining low neutrophil-to-lymphocyte ratio and low platelet-to lymphocyte ratio in this manner is considered to be one of the reasons why eribulin continues to be effective. We encountered a rare case in which eribulin was administered for the longest period of time, and produced an observable effect in uterine LMS.
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Affiliation(s)
- Motoki Matsuura
- Corresponding author at: Department of Obstetrics and Gynecology, Sapporo Medical University, S1 W17, Chuo-ku, Sapporo 060-8543, Japan.
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13
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Xie J, Chen M, Han H, Xu K, Qiu G, Lin X, Song Y, Ye J, Lv T, Zhan P. Clinical impact of first-line PD-1 or PD-L1 inhibitors combined with chemotherapy in extensive-stage small cell lung cancer patients: A real-world multicenter propensity score-matched study. Thorac Cancer 2023; 14:1327-1338. [PMID: 37005095 DOI: 10.1111/1759-7714.14874] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/15/2023] [Accepted: 03/16/2023] [Indexed: 04/04/2023] Open
Abstract
OBJECTIVES Our research aimed to evaluate the effectiveness of first-line immune checkpoint inhibitors (ICIs) with etoposide and platinum (EP) for extensive-stage small cell lung cancer (ES-SCLC) and identify prognostic factors, as real-world outcomes and the inconsistency of PD-1 and PD-L1 inhibitors are uncertain. METHODS We selected ES-SCLC patients in three centers and conducted a propensity score-matched analysis. The Kaplan-Meier method and Cox proportional hazards regression were conducted to compare the survival outcomes. We also performed univariate and multivariate Cox regression analyses to investigate predictors. RESULTS Among 236 patients included, 83 pairs of cases were matched. The EP plus ICIs cohort had a longer median overall survival (OS) (17.3 months) than the EP cohort (13.4 months) (hazard ratio [HR], 0.61 [0.45, 0.83]; p = 0.001). The median progression-free survival (PFS) was also longer in the EP plus ICIs cohort (8.3 months) than in the EP cohort (5.9 months) (HR, 0.44 [0.32, 0.60]; p < 0.001). The EP plus ICIs group had a higher objective response rate (ORR) (EP: 62.3%, EP + ICIs: 84.3%, p < 0.001). Multivariate analysis presented that liver metastases (HR, 2.08; p = 0.018) and lymphocyte-monocyte ratio (LMR) (HR, 0.54; p = 0.049) were independent prognostic factors for OS, and performance status (PS) (HR, 2.11; p = 0.015), liver metastases (HR, 2.64; p = 0.002), and neutrophil-lymphocyte ratio (NLR) (HR, 0.45; p = 0.028) were for PFS in patients with chemo-immunotherapy. CONCLUSION Our real-world data demonstrated that ICIs with chemotherapy as the first-line setting for ES-SCLC are effective and safe. PS, liver metastases, and inflammatory markers could serve as valuable risk factors.
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Affiliation(s)
- Jingyuan Xie
- Department of Respiratory and Critical Care Medicine, Affiliated Jinling Hospital, Medical School, Nanjing University, Nanjing, China
| | - Mo Chen
- Department of Respiratory and Critical Care Medicine, Jinling Hospital, Jinling Clinical College of Nanjing Medical University, Nanjing, China
| | - Hedong Han
- Department of Respiratory and Critical Care Medicine, Affiliated Jinling Hospital, Medical School, Nanjing University, Nanjing, China
| | - Ke Xu
- Department of Respiratory and Critical Care Medicine, Affiliated Jinling Hospital, Medical School, Nanjing University, Nanjing, China
| | - Guihuan Qiu
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Xinqing Lin
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Yong Song
- Department of Respiratory and Critical Care Medicine, Affiliated Jinling Hospital, Medical School, Nanjing University, Nanjing, China
- Department of Respiratory and Critical Care Medicine, Jinling Hospital, Jinling Clinical College of Nanjing Medical University, Nanjing, China
| | - Jinjun Ye
- Department of Radiotherapy, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing, China
| | - Tangfeng Lv
- Department of Respiratory and Critical Care Medicine, Affiliated Jinling Hospital, Medical School, Nanjing University, Nanjing, China
- Department of Respiratory and Critical Care Medicine, Jinling Hospital, Jinling Clinical College of Nanjing Medical University, Nanjing, China
| | - Ping Zhan
- Department of Respiratory and Critical Care Medicine, Affiliated Jinling Hospital, Medical School, Nanjing University, Nanjing, China
- Department of Respiratory and Critical Care Medicine, Jinling Hospital, Jinling Clinical College of Nanjing Medical University, Nanjing, China
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14
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Masuda T, Ueo H, Okumura Y, Kai Y, Ando Y, Masuguchi K, Kitagawa M, Kitagawa A, Hayashi N, Tsuruda Y, Hisamatsu Y, Suehiro S, Ohmura H, Fujiyoshi K, Tanaka F, Mimori K. Dynamic Changes in Peripheral Systemic Immunity Markers During Chemotherapy in HER2-negative Advanced Breast Cancer. Cancer Genomics Proteomics 2023; 20:182-194. [PMID: 36870689 PMCID: PMC9989675 DOI: 10.21873/cgp.20373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 12/15/2022] [Accepted: 12/19/2022] [Indexed: 03/06/2023] Open
Abstract
BACKGROUND/AIM The immune system has a pivotal role in modulating the response to chemotherapy in breast cancer (BC). However, the immune status during chemotherapy remains unclear. We evaluated the sequential changes in peripheral systemic immunity markers in BC patients treated with various chemotherapeutic agents. MATERIALS AND METHODS We examined the correlation between the peripheral systemic immunity markers, neutrophil-to-lymphocyte ratio (NLR), absolute lymphocyte count (ALC) and the local cytolytic activity (CYT) score obtained by quantitative reverse-transcription polymerase chain reaction of 84 preoperative BC patients. Next, we observed the sequential changes in the peripheral systemic immunity markers during treatment with four anticancer drugs: oral 5-fluorouracil derivative; S-1, epirubicin plus cyclophosphamide; paclitaxel plus the anti-vascular endothelial growth factor antibody bevacizumab, and eribulin in 172 HER2-negative advanced BC patients. Finally, we examined the correlation between the changes in the peripheral systemic immunity markers, time to treatment failure (TTF) and progression-free survival (PFS). RESULTS A negative correlation was found between ALC and NLR. ALC-low and NLR-high cases were positively associated with CYT score-low cases. The ratio of ALC-increase and NLR-decrease varies depending on the anticancer drugs used. The responder group (TTF ≥3 months) had a higher NLR-decrease ratio than the nonresponder group (TTF <3 months). Patients with a high NLR-decrease ratio showed higher PFS. CONCLUSION The change in ALC or NLR varies according to the anticancer drugs, suggesting differential immunomodulatory effects of the drugs. Furthermore, the change in NLR reflects the therapeutic efficacy of chemotherapy in advanced BC.
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Affiliation(s)
- Takaaki Masuda
- Department of Surgery, Kyushu University Beppu Hospital, Oita, Japan
| | | | - Yuta Okumura
- Department of Internal Medicine, Kyushu University Beppu Hospital, Oita, Japan
| | | | - Yuki Ando
- Department of Surgery, Kyushu University Beppu Hospital, Oita, Japan
| | - Ken Masuguchi
- Department of Pharmacy, Kyushu University Beppu Hospital, Oita, Japan
| | - Miwa Kitagawa
- Department of Surgery, Kyushu University Beppu Hospital, Oita, Japan.,Department of Breast Surgery, Medical Corporation Kyoujinkai Komatsu Hospital, Osaka, Japan
| | - Akihiro Kitagawa
- Department of Surgery, Kyushu University Beppu Hospital, Oita, Japan.,Department of Surgery, Sakai City Medical Center, Osaka, Japan
| | - Naoki Hayashi
- Department of Surgery, Kyushu University Beppu Hospital, Oita, Japan
| | - Yusuke Tsuruda
- Department of Surgery, Kyushu University Beppu Hospital, Oita, Japan
| | - Yuichi Hisamatsu
- Department of Surgery, Kyushu University Beppu Hospital, Oita, Japan
| | - Shuji Suehiro
- Department of Breast Surgery, Tsurumi Hospital, Oita, Japan
| | - Hirofumi Ohmura
- Department of Internal Medicine, Kyushu University Beppu Hospital, Oita, Japan
| | | | - Fumiaki Tanaka
- Department of Surgery, Kyushu University Beppu Hospital, Oita, Japan.,Tanaka Breast, Surgery, Internal Medicine Clinic, Oita, Japan
| | - Koshi Mimori
- Department of Surgery, Kyushu University Beppu Hospital, Oita, Japan;
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15
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Futamura M, Ishihara K, Nagao Y, Ogiso A, Niwa Y, Nakada T, Kawaguchi Y, Ikawa A, Kumazawa I, Mori R, Kitazawa M, Hosono Y, Kuno M, Kawajiri M, Nakakami A, Takeuchi M, Morikawa A, Tokumaru Y, Katagiri Y, Asano Y, Mushika Y, Shimokawa T, Matsuhasih N. Neoadjuvant chemotherapy using nanoparticle albumin-bound paclitaxel plus trastuzumab and pertuzumab followed by epirubicin and cyclophosphamide for operable HER2-positive primary breast cancer: a multicenter phase II clinical trial (PerSeUS-BC04). Breast Cancer 2023; 30:293-301. [PMID: 36609911 PMCID: PMC9950177 DOI: 10.1007/s12282-022-01425-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 12/09/2022] [Indexed: 01/09/2023]
Abstract
BACKGROUND Nanoparticle albumin-bound paclitaxel (nab-PTX) is a promising antibody partner for anti-human epidermal growth factor receptor 2 (HER2). We performed neoadjuvant chemotherapy (NAC) for HER2-positive breast cancer (BC) using nab-PTX plus trastuzumab (T-mab) and pertuzumab (P-mab), followed by epirubicin and cyclophosphamide (EC). METHODS In this multicenter phase II clinical trial (January 2019-July 2020), patients with stage I (T1c)-IIIB HER2-positive primary BC were treated with four cycles of nab-PTX plus T-mab and P-mab, followed by four cycles of EC. The primary endpoint was the pathological complete response (pCR) rate. Secondary endpoints were clinical response rate (RR), adverse events (AE), and tumor-infiltrating lymphocytes (TILs) in biopsy samples. RESULTS In total, 43 patients were enrolled (mean age, 54 years). Twenty-two patients had HER2, and 21 patients had luminal/HER2-subtypes. The overall pCR rate was 53.5% (23/43, 95% CI: 42.6-64.1%, p = 0.184), whilst the pCR for HER2 was 68.2% (15/22, 95% CI: 45.1-86.1) and 38.1% for luminal/HER2 (8/21, 95% CI: 18.1-61.6%). The RR was 100% [clinical (c) CR:25, partial response (PR): 18]. AEs (≥ G3) included neutropenia (23.3%), leukopenia (7.0%), liver dysfunction (7.0%), and peripheral neuropathy (4.7%) when nab-PTX was administered. EC administration resulted in leukopenia (34.2%), neutropenia (31.6%), and febrile neutropenia (15.8%). The TILs in preoperative biopsy samples were significantly higher in pCR compared to non-pCR samples. CONCLUSION Nab-PTX plus T-mab and P-mab induced a high pCR rate in HER2-positive BC, particularly in the HER2-subtype. Given that AEs are acceptable, this regimen is safe and acceptable as NAC for HER2-positive BC.
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Affiliation(s)
- Manabu Futamura
- Department of Breast Surgery, Gifu University Hospital, 1-1 Yanagido, Gifu, 501-1194, Japan.
| | | | - Yasuko Nagao
- Department of Surgery, Gifu Prefectural General Medical Center, Gifu, Japan
| | - Atsuko Ogiso
- Department of Surgery, Gifu Prefectural General Medical Center, Gifu, Japan
| | - Yoshimi Niwa
- Department of Breast Surgery, Gifu University Hospital, 1-1 Yanagido, Gifu, 501-1194 Japan
| | - Takumi Nakada
- Department of Breast Surgery, Gifu Municipal Hospital, Gifu, 500-8513 Japan
| | - Yoshihiro Kawaguchi
- Department of Breast Surgery, Asahi University Hospital, Gifu, 500-8523 Japan
| | - Ai Ikawa
- Department of Surgery, Takayama Red Cross Hospital, Takayama, 506-8550 Japan
| | - Iwao Kumazawa
- Department of Surgery, Gifu-Seino Medical Center, Ibi Hospital, Ibi, 501-0696 Japan
| | - Ryutaro Mori
- Department of Breast Surgery, Gifu University Hospital, 1-1 Yanagido, Gifu, 501-1194 Japan
| | - Mai Kitazawa
- Department of Breast Surgery, Asahi University Hospital, Gifu, 500-8523 Japan
| | - Yoshiki Hosono
- Department of Breast Surgery, Gifu Municipal Hospital, Gifu, 500-8513 Japan
| | - Masashi Kuno
- Department of Surgery, Gihoku Kosei Hospital, Gifu, 501-2105 Japan
| | - Mana Kawajiri
- Department of Surgery, Gihoku Kosei Hospital, Gifu, 501-2105 Japan
| | - Akira Nakakami
- Department of Breast Surgery, Gifu University Hospital, 1-1 Yanagido, Gifu, 501-1194 Japan
| | - Makoto Takeuchi
- Department of Breast Surgery, Central Japan International Medical Center, Minokamo, 505-8510 Japan
| | - Akemi Morikawa
- Department of Breast Surgery, Central Japan International Medical Center, Minokamo, 505-8510 Japan
| | - Yoshihisa Tokumaru
- Department of Breast Surgery, Gifu University Hospital, 1-1 Yanagido, Gifu, 501-1194 Japan
| | - Yasuo Katagiri
- Department of Pathology, Gifu University Hospital, Gifu, 501-1194 Japan
| | - Yoshimasa Asano
- Department of Surgery, Municipal Ena Hospital, Ena, 509-7201 Japan
| | - Yoshinori Mushika
- Department of Breast Surgery, Daiyukai General Hospital, Ichinomiya, 491-8551 Japan
| | - Toshio Shimokawa
- Clinical Study Support Center, Wakayama Medical University, Wakayama, 614-8509 Japan
| | - Nobuhisa Matsuhasih
- Department of Gastroenterological Surgery, Gifu University Hospital, Gifu, 501-1194 Japan
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16
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Cao W, Yu H, Zhu S, Lei X, Li T, Ren F, Zhou N, Tang Q, Zu L, Xu S. Clinical significance of preoperative neutrophil‐lymphocyte ratio and platelet‐lymphocyte ratio in the prognosis of resected early‐stage patients with non‐small cell lung cancer: A meta‐analysis. Cancer Med 2022; 12:7065-7076. [PMID: 36480232 PMCID: PMC10067053 DOI: 10.1002/cam4.5505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 10/06/2022] [Accepted: 11/20/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Poor prognosis is linked to peripheral blood levels of preoperative platelet-lymphocyte ratio (PLR) and neutrophil-lymphocyte ratio (NLR) in many advanced cancers. Nevertheless, whether the correlation exists in resected early-stage cases with non-small cell lung cancer (NSCLC) stays controversial. Consequently, we performed a meta-analysis to explore the preoperative NLR and PLR's prognostic significance in early-stage patients with NSCLC undergoing curative surgery. METHODS Relevant studies that validated the link between preoperative NLR or PLR and survival results were found via the proceeding databases: PubMed, Embase, Cochrane Library, and Web of Science. The merged 95% confidence interval (CI) and hazard ratio (HR) was employed to validate the link between the NLR or PLR's index and overall survival (OS) and disease-free survival (DFS) in resected NSCLC cases. We used sensitivity and subgroup analyses to assess the studies' heterogeneity. RESULTS An overall of 21 studies were attributed to the meta-analysis. The findings indicated that great preoperative NLR was considerably correlated with poor DFS (HR = 1.58, 95% CI: 1.37-1.82, p < 0.001) and poor OS (HR = 1.51, 95% CI: 1.33-1.72, p < 0.001), respectively. Subgroup analyses were in line with the pooled findings. In aspect of PLR, raised PLR was indicative of inferior DFS (HR = 1.28, 95% CI: 1.04-1.58, p = 0.021) and OS (HR = 1.37, 95% CI: 1.18-1.60, p < 0.001). In the subgroup analyses between PLR and DFS, only subgroups with a sample size <300 (HR = 1.67, 95% CI: 1.15-2.43, p = 0.008) and TNM staging of mixed (I-II) (HR = 1.47, 95% CI: 1.04-2.07, p = 0.028) showed that the link between high PLR and poor DFS was significant. CONCLUSIONS Preoperative elevated NLR and PLR may act as prognostic biomarkers in resected early-stage NSCLC cases and are therefore valuable for guiding postoperative adjuvant treatment.
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Affiliation(s)
- Weibo Cao
- Department of Lung Cancer Surgery Lung Cancer Institute, Tianjin Medical University General Hospital Tianjin China
- Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment Lung Cancer Institute, Tianjin Medical University General Hospital Tianjin China
| | - Haochuan Yu
- Department of Lung Cancer Surgery Lung Cancer Institute, Tianjin Medical University General Hospital Tianjin China
- Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment Lung Cancer Institute, Tianjin Medical University General Hospital Tianjin China
| | - Shuai Zhu
- Department of Lung Cancer Surgery Lung Cancer Institute, Tianjin Medical University General Hospital Tianjin China
- Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment Lung Cancer Institute, Tianjin Medical University General Hospital Tianjin China
| | - Xi Lei
- Department of Lung Cancer Surgery Lung Cancer Institute, Tianjin Medical University General Hospital Tianjin China
- Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment Lung Cancer Institute, Tianjin Medical University General Hospital Tianjin China
| | - Tong Li
- Department of Lung Cancer Surgery Lung Cancer Institute, Tianjin Medical University General Hospital Tianjin China
- Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment Lung Cancer Institute, Tianjin Medical University General Hospital Tianjin China
| | - Fan Ren
- Department of Lung Cancer Surgery Lung Cancer Institute, Tianjin Medical University General Hospital Tianjin China
- Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment Lung Cancer Institute, Tianjin Medical University General Hospital Tianjin China
| | - Ning Zhou
- Department of Lung Cancer Surgery Lung Cancer Institute, Tianjin Medical University General Hospital Tianjin China
- Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment Lung Cancer Institute, Tianjin Medical University General Hospital Tianjin China
| | - Quanying Tang
- Department of Lung Cancer Surgery Lung Cancer Institute, Tianjin Medical University General Hospital Tianjin China
- Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment Lung Cancer Institute, Tianjin Medical University General Hospital Tianjin China
| | - Lingling Zu
- Department of Lung Cancer Surgery Lung Cancer Institute, Tianjin Medical University General Hospital Tianjin China
- Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment Lung Cancer Institute, Tianjin Medical University General Hospital Tianjin China
| | - Song Xu
- Department of Lung Cancer Surgery Lung Cancer Institute, Tianjin Medical University General Hospital Tianjin China
- Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment Lung Cancer Institute, Tianjin Medical University General Hospital Tianjin China
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17
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Jimbo H, Horimoto Y, Ishizuka Y, Nogami N, Shikanai A, Saito M, Watanabe J. Absolute lymphocyte count decreases with disease progression and is a potential prognostic marker for metastatic breast cancer. Breast Cancer Res Treat 2022; 196:291-298. [PMID: 36156756 DOI: 10.1007/s10549-022-06748-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 09/14/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE Peripheral blood parameters such as the neutrophil-to-lymphocyte ratio (NLR) are prognostic markers for breast cancer patients. For instance, patients with a high NLR have a poor prognosis. Meanwhile, high absolute lymphocyte count (ALC) is reportedly a predictive factor for some chemotherapies. However, the underlying mechanisms behind how these markers relate to patient outcomes and how these markers change during the clinical course of patients with metastatic breast cancer (MBC) remains unknown. METHODS We retrospectively investigated 156 patients who were treated for MBC and eventually transitioned to best supportive care (BSC) at our hospital between January 2017 and December 2021. Changes in peripheral blood parameters during MBC treatments and their association with patient outcomes were examined. RESULTS From the time of MBC diagnosis (baseline) through to the transition to BSC, ALC became significantly lower, while the NLR and platelet-to-lymphocyte ratio (PLR) became significantly higher (p < 0.001 for all). This association was independent of hormone receptor status. Cox proportional hazard modeling found patients with hormone receptor-negative and a lower baseline ALC had a significantly shorter overall survival (p = 0.030 and p = 0.019, respectively). CONCLUSION We observed that peripheral blood markers gradually changed with MBC disease progression. Our data suggest that baseline ALC may be a potential prognostic marker after recurrence.
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Affiliation(s)
- Hikari Jimbo
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Yoshiya Horimoto
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
| | - Yumiko Ishizuka
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Noriko Nogami
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.,Department of Palliative Medicine, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Ayana Shikanai
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Mitsue Saito
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Junichiro Watanabe
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
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18
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Sato J, Shimizu T, Koyama T, Iwasa S, Shimomura A, Kondo S, Kitano S, Yonemori K, Fujiwara Y, Tamura K, Suzuki T, Takase T, Nagai R, Yamaguchi K, Semba T, Zhao ZM, Ren M, Yamamoto N. Dose Escalation Data from the Phase 1 Study of the Liposomal Formulation of Eribulin (E7389-LF) in Japanese Patients with Advanced Solid Tumors. Clin Cancer Res 2022; 28:1783-1791. [PMID: 35180771 PMCID: PMC9365350 DOI: 10.1158/1078-0432.ccr-21-3518] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 12/22/2021] [Accepted: 02/16/2022] [Indexed: 01/07/2023]
Abstract
PURPOSE We report the dose-escalation part of a phase I study of liposomal eribulin (E7389-LF) in Japanese patients with advanced solid tumors and no alternative standard therapy. PATIENTS AND METHODS Patients ≥20 years old were enrolled. E7389-LF doses of 1.0 to 1.5 mg/m2 once every two weeks (Q2W) or 1.0 to 2.5 mg/m2 once every three weeks (Q3W) were planned. The primary objective was to determine the MTD by evaluating dose-limiting toxicities (DLT). Secondary objectives included safety/tolerability assessments, objective response rate (ORR), and progression-free survival; serum biomarker assessment was an exploratory objective. RESULTS Twenty-one patients were enrolled and treated; 12 in the Q3W group (1.0 mg/m2, n = 3; 1.5 mg/m2, n = 3; 2.0 mg/m2, n = 6) and 9 in the Q2W group (1.0 mg/m2, n=3; 1.5 mg/m2, n = 6). The Q3W and Q2W MTDs were 2.0 mg/m2 and 1.5 mg/m2, respectively. One patient receiving 2.0 mg/m2 Q3W had a DLT of grade 3 febrile neutropenia. The most common grade 3 treatment-emergent adverse events were neutropenia (66.7% in Q3W and Q2W) and leukopenia (Q3W, 58.3%; Q2W, 33.3%). One patient in the Q3W group (2.0 mg/m2) and 3 in the Q2W group (1.0 mg/m2, n = 1; 1.5 mg/m2, n = 2) achieved a partial response [overall ORR, 19.0%; 95% confidence interval (CI), 5.4-41.9]. Endothelial [TEK receptor tyrosine kinase (TEK), intercellular adhesion molecule 1 (ICAM1), vascular endothelial growth factor receptor 3 (VEGFR3), platelet/endothelial cell adhesion molecule 1 (PECAM1)], vasculature (collagen IV), and immune-related [interferon gamma (IFNγ), C-X-C motif chemokine ligand 11 (CXCL11), C-X-C motif chemokine ligand 10 (CXCL10)] biomarker levels were increased. CONCLUSIONS E7389-LF was well tolerated at 2.0 mg/m2 Q3W and 1.5 mg/m2 Q2W. Considering the toxicity profile of both regimens, the recommended dose was 2.0 mg/m2 Q3W. Expansion cohorts are ongoing.
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Affiliation(s)
- Jun Sato
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo, Japan
| | - Toshio Shimizu
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo, Japan
| | - Takafumi Koyama
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo, Japan
| | - Satoru Iwasa
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo, Japan
| | - Akihiko Shimomura
- Department of Breast and Medical Oncology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Shunsuke Kondo
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo, Japan
| | - Shigehisa Kitano
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo, Japan.,Division of Cancer Immunotherapy Development, Advanced Medical Development Center, The Cancer Institute Hospital of JFCR, Tokyo, Japan
| | - Kan Yonemori
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo, Japan
| | - Yutaka Fujiwara
- Department of Thoracic Oncology, Aichi Cancer Center, Nagoya, Japan
| | - Kenji Tamura
- Department of Respiratory Medicine and Medical Oncology, Faculty of Medicine, Shimane University Hospital, Tokyo, Japan
| | - Takuya Suzuki
- Japan and Asia Clinical Development Department, Oncology Business Group, Eisai Co., Ltd., Tokyo, Japan
| | - Takao Takase
- Clinical Data Science Department, Medicine Development Center, Eisai Co., Ltd., Tokyo, Japan
| | - Reiko Nagai
- Clinical Data Science Department, Medicine Development Center, Eisai Co., Ltd., Tokyo, Japan
| | - Kohei Yamaguchi
- Clinical Pharmacology Science Department, Medicine Development Center, Eisai Co., Ltd., Tokyo, Japan
| | - Taro Semba
- Tsukuba Research Department, Oncology Business Group, Eisai Co., Ltd., Ibaraki, Japan
| | - Zi-Ming Zhao
- Translational Science, Oncology Business Group, Eisai Inc., Nutley, New Jersey
| | - Min Ren
- Biostats, Oncology Business Group, Eisai Inc., Nutley, New Jersey
| | - Noboru Yamamoto
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo, Japan.,Corresponding Author: Noboru Yamamoto, Department of Experimental Therapeutics, National Cancer Center Hospital, 5 Chome-1-1 Tsukiji, Chuo City, Tokyo 104-0045, Japan. Phone: 81-3-3542-2511; E-mail:
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19
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Nikniaz Z, Somi MH, Naghashi S. Malnutrition and Weight Loss as Prognostic Factors in the Survival of Patients with Gastric Cancer. Nutr Cancer 2022; 74:3140-3145. [DOI: 10.1080/01635581.2022.2059089] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Affiliation(s)
- Zeinab Nikniaz
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Hossein Somi
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shahnaz Naghashi
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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20
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Takamizawa S, Shimoi T, Satomi-Tsushita N, Yazaki S, Okuya T, Kojima Y, Sumiyoshi-Okuma H, Nishikawa T, Tanioka M, Sudo K, Noguchi E, Yonemori K. Neutrophil-to-lymphocyte ratio as a prognostic factor for patients with metastatic or recurrent breast cancer treated using capecitabine: a retrospective study. BMC Cancer 2022; 22:64. [PMID: 35027011 PMCID: PMC8759263 DOI: 10.1186/s12885-021-09112-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 12/14/2021] [Indexed: 12/24/2022] Open
Abstract
Background Eribulin or capecitabine monotherapy is the next cytotoxic chemotherapy option for patients with metastatic or recurrent breast cancer who have previously received an anthracycline or a taxane. However, it is unclear what factors can guide the selection of eribulin or capecitabine in this setting, and prognostic factors are needed to guide appropriate treatment selection. The neutrophil-to-lymphocyte ratio (NLR) is a prognostic factor for eribulin-treated patients, although it is unclear whether it is a prognostic factor for capecitabine-treated patients. Therefore, we analysed the ability of the NLR to predict oncological outcomes among patients who received capecitabine after previous anthracycline or taxane treatment for breast cancer. Methods
We retrospectively reviewed the medical records of patients with metastatic or recurrent breast cancer who had previously received anthracycline or taxane treatment at the National Cancer Center Hospital between 2007 and 2015. Patients were included if they received eribulin or capecitabine monotherapy as first-line, second-line, or third-line chemotherapy. Analyses of overall survival (OS) and progression-free survival (PFS) were performed according to various factors. Results Between 2007 and 2015, we identified 125 eligible patients, including 46 patients who received only eribulin, 34 patients who received only capecitabine, and 45 patients who received eribulin and capecitabine. The median follow-up period was 19.1 months. Among eribulin-treated patients, an NLR of <3 independently predicted better OS. Among capecitabine-treated patients, an NLR of <3 independently predicted better PFS but not better OS. In addition, a lymphocyte-to-monocyte ratio of ≥5 was associated with better PFS and OS. Conclusions To the best of our knowledge, this is the first study to evaluate whether the NLR is a prognostic factor for capecitabine-treated patients with metastatic or recurrent breast cancer. However, the NLR only independently predicted PFS in this setting, despite it being a useful prognostic factor for other chemotherapies. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-021-09112-9.
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Affiliation(s)
- Shigemasa Takamizawa
- Department of Medical Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, 104-0045, Tokyo, Japan
| | - Tatsunori Shimoi
- Department of Medical Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, 104-0045, Tokyo, Japan.
| | - Natsuko Satomi-Tsushita
- Department of Medical Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, 104-0045, Tokyo, Japan
| | - Shu Yazaki
- Department of Medical Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, 104-0045, Tokyo, Japan
| | - Toshihiro Okuya
- Department of Medical Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, 104-0045, Tokyo, Japan
| | - Yuki Kojima
- Department of Medical Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, 104-0045, Tokyo, Japan
| | - Hitomi Sumiyoshi-Okuma
- Department of Medical Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, 104-0045, Tokyo, Japan
| | - Tadaaki Nishikawa
- Department of Medical Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, 104-0045, Tokyo, Japan
| | - Maki Tanioka
- Department of Medical Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, 104-0045, Tokyo, Japan
| | - Kazuki Sudo
- Department of Medical Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, 104-0045, Tokyo, Japan
| | - Emi Noguchi
- Department of Medical Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, 104-0045, Tokyo, Japan
| | - Kan Yonemori
- Department of Medical Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, 104-0045, Tokyo, Japan
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21
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Nakamoto S, Watanabe J, Ohtani S, Morita S, Ikeda M. Eribulin improved the overall survival from the initiation of first-line chemotherapy for HER2-negative advanced breast cancer: a multicenter retrospective study. BMC Cancer 2022; 22:31. [PMID: 34980019 PMCID: PMC8722338 DOI: 10.1186/s12885-021-09137-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 12/22/2021] [Indexed: 11/10/2022] Open
Abstract
Background Eribulin methylate (eribulin) improved the overall survival (OS) of eribulin-treated patients with HER2-negative advanced breast cancer (ABC) in prospective and retrospective studies. However, the effect of eribulin on OS as first-line chemotherapy and the characteristics of the patients who benefited from eribulin remain unclear. Methods Between January 2011 and December 2016, 301 patients with HER2-negative ABC who started first-line chemotherapy at 3 institutions were retrospectively evaluated for OS from the initiation of first-line chemotherapy. Results We identified 172 patients (119 estrogen receptor-positive [ER+], 47 ER−, 6 unknown) who received eribulin (eribulin group) and 129 patients (92 ER+, 31 ER−, 6 unknown) who did not receive eribulin (non-eribulin group). The median OS from the initiation of first-line chemotherapy in the two groups was not statistically significant (869 vs. 744 days, P = 0.47, log-rank); however, in patients who received eribulin in later lines (≥3rd-line) and who had a history of perioperative chemotherapy with anthracycline- and/or taxane-based regimens, the median OS improved (1001 vs. 744 days, P = 0.037; and 834 vs. 464 days, respectively P = 0.032, respectively; Wilcoxon). Multivariate analyses revealed that a history of perioperative chemotherapy with anthracycline- and/or taxane-based regimens was a predictive factor (hazard ratio, 0.39; 95% confidence interval, 0.21–0.70) for OS. Conclusions This study successfully identified subgroups of HER2− ABC patients with improved OS by eribulin therapy. Selecting patients according to their background and line of treatment will maximize the efficacy of eribulin therapy.
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Affiliation(s)
- Shogo Nakamoto
- Division of Breast Oncology, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi, Shizuoka, 411-8777, Japan. .,Division of Breast and Thyroid Gland Surgery, Fukuyama City Hospital, 5-23-1 Zao, Fukuyama, Hiroshima, 721-8511, Japan.
| | - Junichiro Watanabe
- Division of Breast Oncology, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi, Shizuoka, 411-8777, Japan
| | - Shoichiro Ohtani
- Division of Breast Surgery, Hiroshima City Hiroshima Citizens Hospital, 7-33 Motomachi, Naka-ku, Hiroshima, Hiroshima, 730-8518, Japan
| | - Satoshi Morita
- Division of Biomedical Statistics and Bioinformatics, Kyoto University Graduate School of Medicine, Yoshida-Konoe, Sakyo-ku, Kyoto, 606-8501, Japan
| | - Masahiko Ikeda
- Division of Breast and Thyroid Gland Surgery, Fukuyama City Hospital, 5-23-1 Zao, Fukuyama, Hiroshima, 721-8511, Japan
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22
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Chen PH, Yeh DC, Tung HH, Lin CY. Prognostic and predictive factors of eribulin in patients with heavily pre-treated metastatic breast cancer. Medicine (Baltimore) 2021; 100:e27859. [PMID: 34964753 PMCID: PMC8615315 DOI: 10.1097/md.0000000000027859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 11/03/2021] [Indexed: 01/05/2023] Open
Abstract
A predictive marker for efficacy of eribulin administered as different lines of treatment in metastatic breast cancer (MBC) has not been identified. We aimed to determine the predictive factors for efficacy of eribulin administered as different lines of treatment in MBC patients.This restrospective cohort study included 49 heavily pre-treated MBC patients who received either eribulin monotherapy or combination therapy with eribulin and anti-Her2 therapy. Associations between clinical response of eribulin-based treatment, time-to-treatment failure (TTF), and possible predictive markers were investigated.Patients' median age was 55 years; 65% were ER+; 43% were HER2+; and 16% were triple-negative. Median TTF was 5.23 months and longer in non-visceral metastases patients. Eastern Cooperative Oncology Group (ECOG) status was 0-1; eribulin as ≥2nd-line treatment; eribulin combined with dual blockades; lymphocyte-monocyte ratio (LMR) ≥3; and monocyte-lymphocyte ratio (MLR) <0.4. In patients with eribulin as >3rd-line treatment, univariate analysis showed that ECOG status was 0-1, and LMR ≥3 and MLR <0.4 were associated with a low risk of TTF. Multivariate analysis showed that ECOG status 0-1 was an independent protective factor. Leukopenia and neutropenia were the most common manageable adverse events.ECOG status is an independent predictor for TTF, while LMR and MLR may have an interactive effect with other biomarkers (e.g., ECOG status) to predict response in MBC patients receiving eribulin as ≥2nd-line treatment.
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Affiliation(s)
- Pei-Hsin Chen
- Department of Breast Medical Center, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tanzi Dist., Taichung City, Taiwan
- School of Nursing, National Yang Ming Chiao Tung University, Beitou Dist., Taipei City, Taiwan
| | - Dah-Cherng Yeh
- Department of Breast Medical Center, Cheng Ching Hospital Chung Kang Branch, Xitun Dist., Taichung City, Taiwan
| | - Heng-Hsin Tung
- School of Nursing, National Yang Ming Chiao Tung University, Beitou Dist., Taipei City, Taiwan
| | - Chin-Yao Lin
- Department of Breast Medical Center, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tanzi Dist., Taichung City, Taiwan
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23
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Brkic FF, Stoiber S, Friedl M, Maier T, Heiduschka G, Kadletz-Wanke L. The Potential Prognostic Value of a Novel Hematologic Marker Fibrinogen-to-Lymphocyte Ratio in Head and Neck Adenoid-Cystic Carcinoma. J Pers Med 2021; 11:jpm11111228. [PMID: 34834580 PMCID: PMC8620294 DOI: 10.3390/jpm11111228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 11/09/2021] [Accepted: 11/17/2021] [Indexed: 11/16/2022] Open
Abstract
Many patients with adenoid-cystic carcinoma (ACC) experience an indolent course of disease over many years but face late recurrence, and long-term survivors are rare. Due to its infrequent occurrence, it is hard to predict outcome in these patients. The fibrinogen-to-lymphocyte ratio (FLR) was recently proposed as an outcome prognosticator in different cancer entities. We aimed to investigate its prognostic relevance in patients with head and neck ACC. This retrospective analysis was performed including all patients treated for ACC between 1998 and 2020. The FLR ratio was calculated based on pretreatment values (0-7 days). The study cohort was dichotomized based on optimized threshold value and compared for differences in outcome (overall survival (OS) and disease-free survival (DFS)). In the cohort of 39 included patients, the OS was significantly longer in the low (n = 28) compared to the high pretreatment FLR group (n = 11) (median OS 150.5 months, 95% confidence intervals (CI) 85.3-215.7 months vs. 29.4 months, 95% CI not reached; p = 0.0093). Similarly, the DFS was significantly longer in the low FLR group (median DFS 74.5 months, 95% CI 30.6-118.4 months vs. 11.0 months, 95% CI 5.1-16.9 months; p = 0.019). The FLR is an easily obtainable and simple marker and may be a valuable outcome prognosticator in patients with ACC. Further studies are needed for validation of our results.
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Affiliation(s)
- Faris F. Brkic
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, 1090 Vienna, Austria; (F.F.B.); (M.F.); (T.M.); (G.H.)
| | - Stefan Stoiber
- Department of Pathology, Medical University of Vienna, 1090 Vienna, Austria;
- Christian Doppler Laboratory for Applied Metabolomics, Medical University of Vienna, 1090 Vienna, Austria
| | - Marlene Friedl
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, 1090 Vienna, Austria; (F.F.B.); (M.F.); (T.M.); (G.H.)
| | - Tobias Maier
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, 1090 Vienna, Austria; (F.F.B.); (M.F.); (T.M.); (G.H.)
| | - Gregor Heiduschka
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, 1090 Vienna, Austria; (F.F.B.); (M.F.); (T.M.); (G.H.)
| | - Lorenz Kadletz-Wanke
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, 1090 Vienna, Austria; (F.F.B.); (M.F.); (T.M.); (G.H.)
- Correspondence: ; Tel.: +43-1-40-400-20830
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Tokumaru Y, Oshi M, Murthy V, Tian W, Yan L, Angarita FA, Nagahashi M, Matsuhashi N, Futamura M, Yoshida K, Miyoshi Y, Takabe K. Low intratumoral genetic neutrophil-to-lymphocyte ratio (NLR) is associated with favorable tumor immune microenvironment and with survival in triple negative breast cancer (TNBC). Am J Cancer Res 2021; 11:5743-5755. [PMID: 34873491 PMCID: PMC8640806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 10/19/2021] [Indexed: 06/13/2023] Open
Abstract
Patients with triple negative breast cancer (TNBC) have a poor prognosis. A novel prognostic biomarker may guide management by appropriately selecting patients for particular treatments. Peripheral blood neutrophil-to-lymphocyte ratio (NLR) was reported to associate with cancer progression, thus we hypothesized that intratumor genetic NLR will reflect tumor immune microenvironment (TIME) and breast cancer biology. The intratumoral genetic NLR previously defined as the ratio of CD66b (CEACAM8) and CD8 (CD8A) gene expressions was utilized to analyze total of 2,994 patients from METABRIC, TCGA, GSE21094, GSE22358, GSE25088, GSE32646, and GSE2603 cohorts. Intratumoral genetic NLR did not correlate with cancer stage nor clinical parameters of cancer cell proliferation such as Nottingham histological grade or MKI67 expression levels in neither the METABRIC or TCGA cohorts. Intratumoral genetic NLR-high breast cancer was not associated with pathologic complete response (pCR) after neoadjuvant chemotherapy in 5 independent cohorts with different regimens. Despite these results, intratumoral genetic NLR-high TNBC demonstrated worse disease-free, disease-specific, and overall survival. Intratumoral genetic NLR-low TNBC enriched multiple immune-related gene sets, was associated with higher favorable immune-related scores and with a favorable TIME, whereas no gene sets enriched to NLR-high TNBC. In conclusion, intratumoral genetic NLR-low TNBC was associated with favorable TIME and with better survival.
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Affiliation(s)
- Yoshihisa Tokumaru
- Breast Surgery, Department of Surgical Oncology, Roswell Park Comprehensive Cancer CenterBuffalo, NY 14263, USA
- Department of Surgical Oncology, Graduate School of Medicine, Gifu University1-1 Yanagido, Gifu 501-1194, Japan
| | - Masanori Oshi
- Breast Surgery, Department of Surgical Oncology, Roswell Park Comprehensive Cancer CenterBuffalo, NY 14263, USA
- Department of Gastroenterological Surgery, Yokohama City University Graduate School of MedicineYokohama 236-0004, Japan
| | - Vijayashree Murthy
- Breast Surgery, Department of Surgical Oncology, Roswell Park Comprehensive Cancer CenterBuffalo, NY 14263, USA
| | - Wanqing Tian
- Department of Biostatistics & Bioinformatics, Roswell Park Comprehensive Cancer CenterBuffalo, NY 14263, USA
| | - Li Yan
- Department of Biostatistics & Bioinformatics, Roswell Park Comprehensive Cancer CenterBuffalo, NY 14263, USA
| | - Fernando A Angarita
- Breast Surgery, Department of Surgical Oncology, Roswell Park Comprehensive Cancer CenterBuffalo, NY 14263, USA
| | - Masayuki Nagahashi
- Department of Surgery, Niigata University Graduate School of Medical and Dental SciencesNiigata 951-8510, Japan
| | - Nobuhisa Matsuhashi
- Department of Surgical Oncology, Graduate School of Medicine, Gifu University1-1 Yanagido, Gifu 501-1194, Japan
| | - Manabu Futamura
- Department of Surgical Oncology, Graduate School of Medicine, Gifu University1-1 Yanagido, Gifu 501-1194, Japan
| | - Kazuhiro Yoshida
- Department of Surgical Oncology, Graduate School of Medicine, Gifu University1-1 Yanagido, Gifu 501-1194, Japan
| | - Yasuo Miyoshi
- Department of Surgery, Division of Breast and Endocrine Surgery, Hyogo College of MedicineNishinomiya 663-8501, Japan
| | - Kazuaki Takabe
- Breast Surgery, Department of Surgical Oncology, Roswell Park Comprehensive Cancer CenterBuffalo, NY 14263, USA
- Department of Gastroenterological Surgery, Yokohama City University Graduate School of MedicineYokohama 236-0004, Japan
- Department of Surgery, Niigata University Graduate School of Medical and Dental SciencesNiigata 951-8510, Japan
- Department of Surgery, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, The State University of New YorkBuffalo, NY 14263, USA
- Department of Breast Oncology and Surgery, Tokyo Medical University6-7-1 Nishishinjuku, Shinjuku, Tokyo 160-8402, Japan
- Department of Breast Surgery, Fukushima Medical University School of MedicineFukushima 960-1295, Japan
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Morisaki T, Kashiwagi S, Asano Y, Goto W, Takada K, Ishihara S, Shibutani M, Tanaka H, Hirakawa K, Ohira M. Prediction of survival after eribulin chemotherapy for breast cancer by absolute lymphocyte counts and progression types. World J Surg Oncol 2021; 19:324. [PMID: 34775950 PMCID: PMC8591927 DOI: 10.1186/s12957-021-02441-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 11/02/2021] [Indexed: 11/22/2022] Open
Abstract
Background In the Response Evaluation Criteria for Solid Tumors (RECIST) diagnostic criteria, the concepts of progression by preexisting disease (PPL) and progression by new metastases (PNM) have been proposed to distinguish between the progression types of cancer refractory to treatment. According to the tumor biology of cancer progression forms, the “PPL” form indicates invasion, and the “PNM” form indicates metastasis. On the other hand, recent studies have focused on the clinical importance of inflammatory markers as indicators of the systemic tumor immune response. In particular, absolute lymphocyte count (ALC) is an indicator of the host’s immune response. Thus, we developed a new measure that combined progression form with ALC. In this study, we clinically validated the combined assessment of progression form and ALC in eribulin chemotherapy. Methods From August 2011 to April 2019, a total of 486 patients with locally advanced or metastatic breast cancer (MBC) underwent treatment. In this study, only 88 patients who underwent chemotherapy using eribulin were included. The antitumor effect was evaluated based on the RECIST criteria, version 1.1. To measure ALC, peripheral blood samples collected before eribulin treatment were used. The cut-off value for ALC in this study was 1500/μl, based on previous studies. Results The PPL group (71 patients, 80.7%) had significantly longer progression-free survival (PFS) (p = 0.022, log-rank) and overall survival (OS) (p < 0.001, log-rank) than the PNM group (17 patients, 19.3%). In the 51 patients with ALC < 1500/μl, the PPL group had a significantly better prognosis than the PNM group (PFS: p = 0.035, OS: p < 0.001, log-rank, respectively). On the other hand, in the 37 patients with ALC ≥ 1500/μl, the PPL group had a better OS compared with the PNM group (p = 0.055, log-rank), but there was no significant difference in PFS between the two groups (p = 0.541, log-rank). Furthermore, multivariate analysis that validated the effect of OS showed that high ORR and “high-ALC and PPL” were factors for a good prognosis (p < 0.001, HR = 0.321; p = 0.036, HR = 0.290). Conclusions The progression form of PNM had a worse prognosis than PPL in patients treated with eribulin. In breast cancer patients with eribulin chemotherapy, good systemic immune status, such as ALC ≥ 1500/μl, was associated with less progression, particularly metastasis, and better prognosis. Furthermore, the biomarker “high-ALC (ALC ≥ 1500/μl) and PPL” was particularly useful as a prognostic marker following eribulin chemotherapy.
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Affiliation(s)
- Tamami Morisaki
- Department of Breast and Endocrine Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan
| | - Shinichiro Kashiwagi
- Department of Breast and Endocrine Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan.
| | - Yuka Asano
- Department of Breast and Endocrine Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan
| | - Wataru Goto
- Department of Breast and Endocrine Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan
| | - Koji Takada
- Department of Breast and Endocrine Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan
| | - Sae Ishihara
- Department of Breast and Endocrine Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan
| | - Masatsune Shibutani
- Department of Gastrointestinal Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan
| | - Hiroaki Tanaka
- Department of Gastrointestinal Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan
| | - Kosei Hirakawa
- Department of Breast and Endocrine Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan.,Department of Gastrointestinal Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan
| | - Masaichi Ohira
- Department of Breast and Endocrine Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan.,Department of Gastrointestinal Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan
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Shorter duration of first-line chemotherapy reflects poorer outcomes in patients with HER2-negative advanced breast cancer: a multicenter retrospective study. Sci Rep 2021; 11:21454. [PMID: 34728668 PMCID: PMC8563944 DOI: 10.1038/s41598-021-00711-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 10/15/2021] [Indexed: 11/09/2022] Open
Abstract
Post-progression survival affects overall survival (OS) in patients with HER2-negative advanced breast cancer (HER2-ABC); thus, the optimal choice of first-line chemotherapy (1LCT) remains controversial. We investigated patients with HER2-ABC focusing on their sensitivity to 1LCT. We retrospectively analyzed patients with HER2-ABC who received 1LCT between January 2011 and December 2016 in three participating institutions. We identified 149 patients in the shorter and 152 patients in the longer time to treatment failure (TTF) groups. The median OS was significantly longer in the longer TTF group (hazard ratio [HR] 0.44, P < 0.001, log-rank). In the shorter TTF group, OS of patients who received paclitaxel plus bevacizumab (PB) therapy was significantly inferior to that of those who received chemotherapy other than PB (HR 2.57, P < 0.001, log-rank), and subsequent eribulin therapy significantly improved OS from 1LCT initiation (Wilcoxon P < 0.001); multivariate analyses showed that 1LCT PB therapy was an independent risk factor for poorer OS (HR 2.05, P = 0.003), while subsequent eribulin therapy was an independent prognostic factor for better OS (HR 0.56, P = 0.004). OS was significantly poorer in patients with HER2-ABC with a shorter duration of 1LCT, including PB therapy, while subsequent eribulin therapy improved OS.
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Koyama Y, Kawai S, Uenaka N, Okazaki M, Asaoka M, Teraoka S, Ueda AI, Miyahara K, Kawate T, Kaise H, Yamada K, Ishikawa T. Absolute Lymphocyte Count, Platelet-to-Lymphocyte Ratio, and Overall Survival in Eribulin-treated HER2-negative Metastatic Breast Cancer Patients. CANCER DIAGNOSIS & PROGNOSIS 2021; 1:435-441. [PMID: 35403160 PMCID: PMC8962857 DOI: 10.21873/cdp.10058] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 09/23/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND/AIM To investigate the utility of peripheral blood biomarkers - absolute lymphocyte count (ALC), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) - for predicting outcomes in eribulin-treated patients with metastatic human epidermal growth factor receptor type 2 (HER2)-negative breast cancer. PATIENTS AND METHODS ALC, NLR, and PLR were retrospectively obtained from pre-treatment blood sampling results of 120 patients and stratified according to means. Univariate and multivariate analyses were performed to investigate the association of clinicopathological factors, including these values, with overall survival (OS) and progression-free survival (PFS). RESULTS The ALC, NLR, and PLR cut-off points were 1,285/μl, 3.3, and 235, respectively. No biomarkers were associated with PFS. However, univariate analysis showed ALC (p=0.044) and PLR (p=0.044) to be significantly associated with OS. CONCLUSION ALC and PLR can predict eribulin efficacy in terms of OS, reflecting the antitumour immune response in the microenvironment and indicating eribulin's effectiveness.
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Affiliation(s)
- Yoichi Koyama
- Department of Breast Oncology and Surgery, Tokyo Medical University, Tokyo, Japan
| | - Saori Kawai
- Department of Breast Oncology and Surgery, Tokyo Medical University, Tokyo, Japan
| | - Natsuki Uenaka
- Department of Breast Oncology and Surgery, Tokyo Medical University, Tokyo, Japan
| | - Miki Okazaki
- Department of Breast Oncology and Surgery, Tokyo Medical University, Tokyo, Japan
| | - Mariko Asaoka
- Department of Breast Oncology and Surgery, Tokyo Medical University, Tokyo, Japan
| | - Saeko Teraoka
- Department of Breast Oncology and Surgery, Tokyo Medical University, Tokyo, Japan
| | - A I Ueda
- Department of Breast Oncology and Surgery, Tokyo Medical University, Tokyo, Japan
| | - Kana Miyahara
- Department of Breast Oncology and Surgery, Tokyo Medical University, Tokyo, Japan
| | - Takahiko Kawate
- Department of Breast Oncology and Surgery, Tokyo Medical University, Tokyo, Japan
| | - Hiroshi Kaise
- Department of Breast Oncology and Surgery, Tokyo Medical University, Tokyo, Japan
| | - Kimito Yamada
- Department of Breast Oncology and Surgery, Tokyo Medical University Hachioji Medical Centre, Tokyo, Japan
| | - Takashi Ishikawa
- Department of Breast Oncology and Surgery, Tokyo Medical University, Tokyo, Japan
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Nakamoto S, Ikeda M, Kubo S, Yamamoto M, Yamashita T, Kuwahara C. The Systemic Immune Markers at Diagnosis Can Predict the Survival Benefit in Advanced Breast Cancer. CANCER DIAGNOSIS & PROGNOSIS 2021; 1:471-478. [PMID: 35403159 PMCID: PMC8962865 DOI: 10.21873/cdp.10063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 10/07/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND/AIM It has been difficult to establish prognostic markers for overall survival (OS) in patients with advanced breast cancer (ABC). Although systemic immune markers were reported as prognostic markers in several cancers, their utility in ABC remains unclear. PATIENTS AND METHODS We retrospectively analyzed 331 ABC patients, who received treatment at Fukuyama City Hospital between April 2009 and December 2020. RESULTS Patients with high absolute lymphocyte count (ALC), low neutrophil-to-lymphocyte ratio (NLR), and high lymphocyte-to-monocyte ratio (LMR) had significantly longer OS (p=0.025, p=0.010, and p<0.001, respectively). High ALC and high LMR were independently associated with longer OS (p=0.020 and p=0.015, respectively). High ALC was also independently associated with longer time to treatment failure (p=0.014). CONCLUSION These systemic immune markers at diagnosis can predict not only a better OS but also a better TTF after first-line treatment.
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Affiliation(s)
- Shogo Nakamoto
- Division of Breast and Thyroid Gland Surgery, Fukuyama City Hospital, Hiroshima, Japan
| | - Masahiko Ikeda
- Division of Breast and Thyroid Gland Surgery, Fukuyama City Hospital, Hiroshima, Japan
| | - Shinichiro Kubo
- Division of Breast and Thyroid Gland Surgery, Fukuyama City Hospital, Hiroshima, Japan
| | - Mari Yamamoto
- Division of Breast and Thyroid Gland Surgery, Fukuyama City Hospital, Hiroshima, Japan
| | - Tetsumasa Yamashita
- Division of Breast and Thyroid Gland Surgery, Fukuyama City Hospital, Hiroshima, Japan
| | - Chihiro Kuwahara
- Division of Breast and Thyroid Gland Surgery, Fukuyama City Hospital, Hiroshima, Japan
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Shimada E, Endo M, Matsumoto Y, Tsuchihashi K, Ito M, Kusaba H, Nabeshima A, Nawata T, Maekawa A, Matsunobu T, Setsu N, Fujiwara T, Iida K, Nakagawa M, Hirose T, Kanahori M, Oyama R, Isobe T, Ariyama H, Kohashi K, Yamamoto H, Oda Y, Iwamoto Y, Akashi K, Baba E, Nakashima Y. Does the Use of Peripheral Immune-Related Markers Indicate Whether to Administer Pazopanib, Trabectedin, or Eribulin to Advanced Soft Tissue Sarcoma Patients? J Clin Med 2021; 10:jcm10214972. [PMID: 34768491 PMCID: PMC8584915 DOI: 10.3390/jcm10214972] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 10/23/2021] [Accepted: 10/25/2021] [Indexed: 11/16/2022] Open
Abstract
Pazopanib, trabectedin, and eribulin are administered for the treatment of soft tissue sarcomas (STSs); however, there is little consensus on which agent should be preferentially used in a clinical setting. This study assessed whether peripheral immune-related markers served as a useful reference when selecting pazopanib, trabectedin, or eribulin. This study included 63 patients who were administered pazopanib, trabectedin, or eribulin for advanced STSs between March 2015 and December 2020. Patients were divided into three groups based on the first drug administered among these three drugs. Differences in overall survival (OS) or progression-free survival (PFS) among the three groups were analyzed. OS showed no significant differences among the drugs administered first. For patients with low neutrophil-to-lymphocyte ratio (NLR), the OS of patients administered pazopanib as the first choice was shorter than the others (hazard ratio [HR] = 9.53, 95% confidence interval [CI] = 1.94–18.13, p = 0.0018). In the low platelet-to-lymphocyte ratio (PLR) subgroup, the OS of the patients administered eribulin for the first choice was longer than that of the others (HR = 0.32, 95%CI = 0.10–0.98, p = 0.046). Therefore, NLR and PLR might be used as prognostic indicators to dictate whether STS patients receive pazopanib, trabectedin, or eribulin.
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Affiliation(s)
- Eijiro Shimada
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; (E.S.); (Y.M.); (A.N.); (N.S.); (T.F.); (K.I.); (M.N.); (T.H.); (M.K.); (R.O.); (Y.N.)
| | - Makoto Endo
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; (E.S.); (Y.M.); (A.N.); (N.S.); (T.F.); (K.I.); (M.N.); (T.H.); (M.K.); (R.O.); (Y.N.)
- Correspondence: ; Tel.: +81-92-642-5488
| | - Yoshihiro Matsumoto
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; (E.S.); (Y.M.); (A.N.); (N.S.); (T.F.); (K.I.); (M.N.); (T.H.); (M.K.); (R.O.); (Y.N.)
| | - Kenji Tsuchihashi
- Department of Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; (K.T.); (M.I.); (H.K.); (H.A.); (K.A.)
| | - Mamoru Ito
- Department of Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; (K.T.); (M.I.); (H.K.); (H.A.); (K.A.)
| | - Hitoshi Kusaba
- Department of Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; (K.T.); (M.I.); (H.K.); (H.A.); (K.A.)
| | - Akira Nabeshima
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; (E.S.); (Y.M.); (A.N.); (N.S.); (T.F.); (K.I.); (M.N.); (T.H.); (M.K.); (R.O.); (Y.N.)
| | - Tomoya Nawata
- Department of Orthopaedic Surgery, Kyushu Rosai Hospital, 1-1, Sonekita, Kokuraminami-ku, Kitakyushu, Fukuoka 800-0296, Japan; (T.N.); (A.M.); (T.M.); (Y.I.)
| | - Akira Maekawa
- Department of Orthopaedic Surgery, Kyushu Rosai Hospital, 1-1, Sonekita, Kokuraminami-ku, Kitakyushu, Fukuoka 800-0296, Japan; (T.N.); (A.M.); (T.M.); (Y.I.)
| | - Tomoya Matsunobu
- Department of Orthopaedic Surgery, Kyushu Rosai Hospital, 1-1, Sonekita, Kokuraminami-ku, Kitakyushu, Fukuoka 800-0296, Japan; (T.N.); (A.M.); (T.M.); (Y.I.)
| | - Nokitaka Setsu
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; (E.S.); (Y.M.); (A.N.); (N.S.); (T.F.); (K.I.); (M.N.); (T.H.); (M.K.); (R.O.); (Y.N.)
| | - Toshifumi Fujiwara
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; (E.S.); (Y.M.); (A.N.); (N.S.); (T.F.); (K.I.); (M.N.); (T.H.); (M.K.); (R.O.); (Y.N.)
| | - Keiichiro Iida
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; (E.S.); (Y.M.); (A.N.); (N.S.); (T.F.); (K.I.); (M.N.); (T.H.); (M.K.); (R.O.); (Y.N.)
| | - Makoto Nakagawa
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; (E.S.); (Y.M.); (A.N.); (N.S.); (T.F.); (K.I.); (M.N.); (T.H.); (M.K.); (R.O.); (Y.N.)
| | - Takeshi Hirose
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; (E.S.); (Y.M.); (A.N.); (N.S.); (T.F.); (K.I.); (M.N.); (T.H.); (M.K.); (R.O.); (Y.N.)
| | - Masaya Kanahori
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; (E.S.); (Y.M.); (A.N.); (N.S.); (T.F.); (K.I.); (M.N.); (T.H.); (M.K.); (R.O.); (Y.N.)
| | - Ryunosuke Oyama
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; (E.S.); (Y.M.); (A.N.); (N.S.); (T.F.); (K.I.); (M.N.); (T.H.); (M.K.); (R.O.); (Y.N.)
| | - Taichi Isobe
- Department of Oncology and Social Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; (T.I.); (E.B.)
| | - Hiroshi Ariyama
- Department of Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; (K.T.); (M.I.); (H.K.); (H.A.); (K.A.)
| | - Kenichi Kohashi
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; (K.K.); (H.Y.); (Y.O.)
| | - Hidetaka Yamamoto
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; (K.K.); (H.Y.); (Y.O.)
| | - Yoshinao Oda
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; (K.K.); (H.Y.); (Y.O.)
| | - Yukihide Iwamoto
- Department of Orthopaedic Surgery, Kyushu Rosai Hospital, 1-1, Sonekita, Kokuraminami-ku, Kitakyushu, Fukuoka 800-0296, Japan; (T.N.); (A.M.); (T.M.); (Y.I.)
| | - Koichi Akashi
- Department of Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; (K.T.); (M.I.); (H.K.); (H.A.); (K.A.)
| | - Eishi Baba
- Department of Oncology and Social Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; (T.I.); (E.B.)
| | - Yasuharu Nakashima
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; (E.S.); (Y.M.); (A.N.); (N.S.); (T.F.); (K.I.); (M.N.); (T.H.); (M.K.); (R.O.); (Y.N.)
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Pérez-García JM, Llombart-Cussac A, G Cortés M, Curigliano G, López-Miranda E, Alonso JL, Bermejo B, Calvo L, Carañana V, de la Cruz Sánchez S, M Vázquez R, Prat A, R Borrego M, Sampayo-Cordero M, Seguí-Palmer MÁ, Soberino J, Malfettone A, Schmid P, Cortés J. Pembrolizumab plus eribulin in hormone-receptor-positive, HER2-negative, locally recurrent or metastatic breast cancer (KELLY): An open-label, multicentre, single-arm, phase Ⅱ trial. Eur J Cancer 2021; 148:382-394. [PMID: 33794440 DOI: 10.1016/j.ejca.2021.02.028] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 02/01/2021] [Accepted: 02/03/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND Pembrolizumab has modest activity if used in patients with hormone-receptor-positive (HR+), HER2-negative, previously treated metastatic breast cancer (BC). Our study investigated whether there would be any clinical benefit in combining chemotherapy with pembrolizumab in a similar patient population. METHODS This single-arm, phase Ⅱ trial enrolled women aged ≥18 years with HR+, HER2-negative, inoperable, locally recurrent or metastatic BC. Patients were previously treated with hormonal therapy and 1-2 chemotherapy regimens for locally recurrent and/or metastatic BC. On each 21-day cycle, patients received intravenous pembrolizumab 200 mg on day 1 and eribulin 1∙23 mg/m2 on days 1 and 8. The primary endpoint was the clinical benefit rate. Analysis of safety and activity was carried out in all patients who met the screening criteria and received at least 1 dose of study treatment. The trial is registered at ClinicalTrials.gov, NCT03222856. RESULTS Of the 44 patients enrolled between January 29 and October 17, 2018, clinical benefit was achieved in 25 (56∙8%, 95% confidence interval [CI]: 41∙0-71∙7), objective response in 18 (40∙9%, 95% CI: 26∙3-56∙8), median progression-free survival was 6∙0 months (95% CI: 3∙7-8∙4), and 1-year overall survival was 59∙1% (95% CI: 45∙8-76∙2). The most common treatment-emergent adverse events (AEs) of any grade were neutropenia (20 [45∙5%]), anaemia (17 [38∙6%]), alopecia (19 [43∙2%]), asthenia (19 [43∙2%]), diarrhoea (14 [31∙8%]), fatigue (14 [31∙8%]), and peripheral neuropathy (12 [27∙3%]). Serious AEs occurred in 14 (31∙8%) patients including febrile neutropenia (3 [6∙8%]), neutropenia (2 [4∙5%]), fever (2 [4∙5%]) and peripheral neuropathy (2 [4∙5%]). Immune-related AEs occurred in 11 (25∙0%) patients. One (2∙3%) patient died of cardiac arrest unrelated to study treatment. CONCLUSION Pembrolizumab plus eribulin demonstrates encouraging antitumour activity in patients with heavily pre-treated, HR+, HER2-negative, locally recurrent or metastatic BC. The safety and tolerability of the combination is similar to eribulin or pembrolizumab monotherapy.
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Affiliation(s)
- José M Pérez-García
- International Breast Cancer Center (IBCC), Quiron Group, Barcelona, Spain; Medica Scientia Innovation Research (MEDSIR), Ridgewood, NJ, USA; Medica Scientia Innovation Research (MEDSIR), Barcelona, Spain
| | - Antonio Llombart-Cussac
- Medica Scientia Innovation Research (MEDSIR), Ridgewood, NJ, USA; Medica Scientia Innovation Research (MEDSIR), Barcelona, Spain; Hospital Arnau de Vilanova Universidad Católica de Valencia "San Vicente Mártir"Valencia, Spain
| | | | | | - Elena López-Miranda
- Medica Scientia Innovation Research (MEDSIR), Ridgewood, NJ, USA; Medica Scientia Innovation Research (MEDSIR), Barcelona, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - José L Alonso
- Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
| | - Begoña Bermejo
- Hospital Clínico de Valencia, INCLIVA, CIBERONC, Valencia, Spain
| | - Lourdes Calvo
- Complejo Hospitalario Universitario A Coruña (CHUAC), A Coruña, Spain
| | | | | | | | - Aleix Prat
- Department of Medical Oncology, Hospital Clinic of Barcelona, Barcelona, Spain; Translational Genomics and Targeted Therapies Group, IDIBAPS, Barcelona, Spain; Department of Medicine, University of Barcelona, Barcelona, Spain
| | | | - Miguel Sampayo-Cordero
- Medica Scientia Innovation Research (MEDSIR), Ridgewood, NJ, USA; Medica Scientia Innovation Research (MEDSIR), Barcelona, Spain
| | | | - Jesus Soberino
- IOB, Institute of Oncology, QuironSalud Group, Barcelona, Spain
| | - Andrea Malfettone
- Medica Scientia Innovation Research (MEDSIR), Ridgewood, NJ, USA; Medica Scientia Innovation Research (MEDSIR), Barcelona, Spain
| | - Peter Schmid
- Barts ECMC, Barts Cancer Institute, Queen Mary University of London, London, United Kingdom; Barts Hospital NHS Trust, London, United Kingdom
| | - Javier Cortés
- International Breast Cancer Center (IBCC), Quiron Group, Barcelona, Spain; Medica Scientia Innovation Research (MEDSIR), Ridgewood, NJ, USA; Medica Scientia Innovation Research (MEDSIR), Barcelona, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain.
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Systemic immunity markers associated with lymphocytes predict the survival benefit from paclitaxel plus bevacizumab in HER2 negative advanced breast cancer. Sci Rep 2021; 11:6328. [PMID: 33737682 PMCID: PMC7973794 DOI: 10.1038/s41598-021-85948-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 03/02/2021] [Indexed: 01/04/2023] Open
Abstract
Although paclitaxel plus bevacizumab (PB) therapy is an effective chemotherapeutic regimen for HER2-negative advanced breast cancer (ABC), predictive markers for its effectiveness remain undefined. We investigated the usefulness of systemic immunity markers associated with lymphocytes as predictive markers for PB therapy in patients with HER2-negative ABC. We retrospectively reviewed data from 114 patients with HER2-negative ABC who underwent PB therapy from November 2011 to December 2019. We calculated the absolute lymphocyte count (ALC), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) as representative systemic immunity markers. The time to treatment failure (TTF) and overall survival (OS) of the patients with high ALC, low NLR, and high LMR were significantly longer compared with those of the patients with low ALC, high NLR, and low LMR. A multivariable analysis revealed that high ALC, low NLR, and low PLR were independent predictors for TTF and high ALC, low NLR, and high LMR were independent predictors for OS. Systemic immunity markers were significantly associated with longer TTF and OS in patients who underwent PB therapy and may represent predictive markers for PB therapy in patients with HER2-negative ABC.
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Takahashi M, Inoue K, Mukai H, Yamanaka T, Egawa C, Miyoshi Y, Sakata Y, Muramoto K, Ikezawa H, Matsuoka T, Tsurutani J. Indices of peripheral leukocytes predict longer overall survival in breast cancer patients on eribulin in Japan. Breast Cancer 2021; 28:945-955. [PMID: 33677779 PMCID: PMC8213560 DOI: 10.1007/s12282-021-01232-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 02/22/2021] [Indexed: 11/30/2022]
Abstract
Background It was reported that eribulin regulates the tumor microenvironment, including the immune system, by inducing vascular remodeling. Lymphocyte counts are a critical index of immune response in patients. The non-Asian, global EMBRACE study has suggested that baseline absolute lymphocyte count (ALC) may be a predictor of the survival benefit of eribulin in breast cancer patients. We examined whether the baseline ALC is a potential predictor of overall survival (OS) in Japanese patients with HER2-negative advanced breast cancer treated with eribulin. Methods This was a post hoc analysis of data from a post-marketing observational study of eribulin in Japan. The OS by baseline ALC was estimated using the Kaplan–Meier method, with the cut-off value of 1500/μL for ALC. The OS by baseline neutrophil-to-lymphocyte ratio (NLR), a general prognostic index in breast cancer patients, was also estimated, with the cut-off value of 3. Results The median OS was longer in patients with an ALC of ≥ 1500/μL than in those with an ALC of < 1500/μL (19.4 vs. 14.3 months; hazard ratio [HR]: 0.628; 95% confidence interval [CI]: 0.492, 0.801). Patients with an NLR of ≥ 3 showed shorter OS than those with an NLR of < 3 (13.2 vs. 18.8 months; HR: 1.552; 95% CI 1.254, 1.921), and NLR also separated OS in patients with an ALC of < 1500/μL. Conclusions Consistent with the findings of a previous study involving a non-Asian, Western population, our study suggested that baseline ALC may be a predictive factor for the survival benefit of eribulin in Japanese patients. Supplementary Information The online version contains supplementary material available at 10.1007/s12282-021-01232-1.
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Affiliation(s)
- Masato Takahashi
- Department of Breast Surgery, National Hospital Organization Hokkaido Cancer Center, 2-3-54, Kikusuishijo, Shiroishi-ku, Sapporo, Hokkaido, 003-0804, Japan.
| | - Kenichi Inoue
- Division of Breast Oncology, Saitama Cancer Center, Kitaadachi-gun, Saitama, Japan
| | - Hirofumi Mukai
- Division of Breast and Medical Oncology, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Takashi Yamanaka
- Department of Breast and Endocrine Surgery, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Chiyomi Egawa
- Department of Breast Surgery, Kansai Rosai Hospital, Amagasaki, Hyogo, Japan
| | - Yasuo Miyoshi
- Division of Breast and Endocrine Surgery, Department of Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | | | | | | | | | - Junji Tsurutani
- Advanced Cancer Translational Research Institute, Showa University, Shinagawa-ku, Tokyo, Japan
- Department of Medical Oncology, Kindai University, Osaka-Sayama, Osaka, Japan
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Yuan P, Xu B. Clinical Utility of Eribulin Mesylate in the Treatment of Breast Cancer: A Chinese Perspective. BREAST CANCER-TARGETS AND THERAPY 2021; 13:135-150. [PMID: 33658845 PMCID: PMC7917473 DOI: 10.2147/bctt.s231298] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 01/12/2021] [Indexed: 12/23/2022]
Abstract
Eribulin mesylate, a synthetic derivative of the anti-mitotic agent halichondrin B, has a unique tubulin-based mechanism of action that is distinct from other anti-microtubule agents including taxanes and vinca alkaloids. Consistent with this unique activity, eribulin has shown clinical efficacy in patients with metastatic breast cancer (MBC) that progressed following prior taxane and anthracycline therapy. The evidence presented in this review indicates that eribulin represents a treatment option for patients with HER2-negative metastatic breast cancer. Improved survival outcomes and better tolerability compared with vinorelbine supported the first approval of eribulin in China in 2019; eribulin was approved for women with locally advanced/metastatic HER2-negative breast cancer after treatment failure with at least two chemotherapy regimens, including an anthracycline and a taxane. Eribulin has also shown promising efficacy in patients with HER2-positive advanced breast cancer when used in combination with trastuzumab or pertuzumab, and subgroup analyses from the Phase III clinical trials support the continued evaluation of eribulin in patients with triple-negative disease. The unique non-mitotic effects of eribulin, including vascular remodeling, coupled with its clinical efficacy and safety profile, may permit the broader use of this agent in patients with MBC.
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Affiliation(s)
- Peng Yuan
- National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, People's Republic of China
| | - Binghe Xu
- National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, People's Republic of China
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Clinical importance of the absolute count of neutrophils, lymphocytes, monocytes, and platelets in newly diagnosed hepatocellular carcinoma. Sci Rep 2021; 11:2614. [PMID: 33510378 PMCID: PMC7844216 DOI: 10.1038/s41598-021-82177-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 01/18/2021] [Indexed: 02/08/2023] Open
Abstract
Although several studies have confirmed the clinical significance of the systemic inflammation markers in hepatocellular carcinoma (HCC), evaluating the clinical significance of each blood cell remains to be conducted. We aimed to evaluate the clinical importance of absolute counts of blood cells in the overall survival (OS) of patients with newly diagnosed HCC. We recruited patient cohorts from the prospective registry of newly diagnosed and previously untreated HCC at Samsung Medical Center, which included a training set of 6619 patients (2005–2013) and a validation set of 2084 patients (2014–2016). More than three-quarters of all patients had hepatitis B virus (HBV)-related HCC in both training and validation sets. The optimal cutoff values of the absolute counts of neutrophils, lymphocytes, monocytes, and platelets were 3917, 488, 1379, and 22,100, respectively, which correlated significantly with OS. The absolute blood cell counts categorized by each optimal cutoff value significantly correlated with liver function status determined by Child–Pugh class/albumin-bilirubin (ALBI) grade and the HCC burden determined by several staging systems/portal vein tumor thrombosis. Although the prognostic model based on these blood cells (ABC model) showed a lower prognostic ability than the Japan Integrated Staging or ALBI-T staging systems, it provided significant discrimination of survival in the subgroups of ALBI-T and showed the highest prognostic ability in the present study in the training and validation sets. Absolute counts of blood cells are independently associated with OS, though it is also significantly associated with liver function and tumor burden in newly diagnosed HCC.
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