Predictive Value of Lymphocyte-Related Blood Parameters of before Ado-Trastuzumab Emtansin Treatment in Breast Cancer
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Date
2022
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Abstract
Objective: Ado-Trastuzumab Emtansine ( TDM1) has been used in the treatment of HER2 metastatic breast cancer after
FDA approval as an antibody-drug conjugate. Some markers may be predictive for clinician in the management of this
TDM1 therapy. There is a need for simple and cost-effective markers to show the treatment response. The primary aim
of this study is to establish a correlation between progression free survival and pre-treatment hematological inflammatory
parameters [absolute lymphocyte count (ALC), neutrophil-to-lymphocyte ratio (NLR), and platelet-lymphocyte
ratio (PLR)] in advance breast cancer.
Methods: Forty-one female patients with metastatic HER-2 positive breast cancer who received TDM-1 between 2016
and 2021 were evaluated retrospectively. NLR and PLR were calculated with the values of neutrophils, lymphocytes,
and trombocytes in complete blood count at the time of diagnosis. The cut off values of NLR and PLR were determined
using receiver operating characteristic (ROC) curve analysis. Overall survival (OS) and progression free survival (PFS)
associated with prior treatment NLR, PLR, ALC were performed by Kaplan-Meier method.
Results: Median age was 49.5 years years (26-76).Patients divided into 2 groups according to NLR cut-off and TLR cutoff
values as NLR/TLR high and low groups. The cut-off values of NLR and TLR were 144.0, and 2.74, respectively. ALC
divided into 2 groups. There was no significant difference in OS between NLR ,PLR,ALC (high/low) groups. (p=0.04, 0.15,
0.53 respectively). There was only significant difference in PFS (high/low) groups.(p=0.81, 0.99, 0.96 respectively).
Conclusions: The predictive value of pre-treatment only NLR on the therapeutic potential in patients with metastatic
breast cancer treated with TDM1.