1. Baseline neutrophil-to-lymphocyte ratio and c-reactive protein predict efficacy of treatment with bevacizumab plus paclitaxel for locally advanced or metastatic breast cancer
- Author
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Ai Yamaguchi, Michiko Imamura, Yuki Okada, Tomoe Taji, Arisa Nishimukai, Tomoko Higuchi, Ayako Yanai, Takashi Morimoto, Takehiro Yanagawa, Ayako Bun, Hirofumi Suwa, Yuichiro Kikawa, Yasuo Miyoshi, Yoshimasa Miyagawa, Atsushi Sata, Hiromi Ozawa, Chiyomi Egawa, Kaori Takamoto, Yukie Fujimoto, Reiko Fukui, and Junichi Inatome
- Subjects
0301 basic medicine ,medicine.medical_specialty ,Bevacizumab ,bevacizumab ,Gastroenterology ,03 medical and health sciences ,chemistry.chemical_compound ,breast cancer ,0302 clinical medicine ,Breast cancer ,c-reactive protein ,neutrophil-to-lymphocyte ratio ,Internal medicine ,medicine ,Neutrophil to lymphocyte ratio ,Predictive marker ,biology ,business.industry ,C-reactive protein ,Hazard ratio ,medicine.disease ,Metastatic breast cancer ,030104 developmental biology ,Oncology ,Paclitaxel ,chemistry ,030220 oncology & carcinogenesis ,biology.protein ,business ,predictive marker ,Research Paper ,medicine.drug - Abstract
The effect of bevacizumab plus paclitaxel therapy on progression-free survival (PFS) is prominent; however, no overall survival (OS) benefit has been demonstrated. Our aim was to study the predictive efficacy of peripheral immune-related parameters, neutrophil-to-lymphocyte ratio (NLR), absolute lymphocyte count (ALC), and c-reactive protein (CRP) in locally advanced and metastatic breast cancers. A total of 179 patients treated with bevacizumab plus paclitaxel were recruited from three institutes in the test cohort. The cut-off values of NLR, ALC, and CRP were set at 3, 1500/μL, and 1.0 mg/dL, respectively, and baseline values of these factors were measured. The PFS of patients with NLR-low was significantly longer than that of patients with -high (median, 12.6 vs. 7.2 months; hazard ratio (HR), 0.48, 95% confidence interval (95% CI), 0.31–0.73; p = 0.0004). OS of patients with NLR-low was significantly better than those with-high (22.2 vs. 13.5 months; HR, 0.57, 95% CI, 0.39–0.83; p = 0.0032). Similarly, improved PFS and OS were recognized in patients with CRP-low as compared with patients with -high (HR, 0.44, 95% CI, 0.28–0.68; p = 0.0001 and HR, 0.39, 95% CI, 0.26–0.61, p < 0.0001, respectively). In the validation cohort from two institutes (n = 57), similar significant improvements in PFS and OS were confirmed for patients with NLR-low (p = 0.0344 and p = 0.0233, respectively) and CRP-low groups (p < 0.0001 and p = 0.0001, respectively). Low levels of NLR and CRP at baseline were significantly associated with improved prognosis in patients treated with bevacizumab plus paclitaxel.
- Published
- 2020