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.
Highlights
Paclitaxel plus bevacizumab (PB) therapy is an effective chemotherapeutic regimen for human epidermal growth factor receptor 2 (HER2)-negative advanced breast cancer (ABC), predictive markers for its effectiveness remain undefined
Our results identified that patients with HER2-negative ABC and high absolute lymphocyte count (ALC), low neutrophil-to-lymphocyte ratio (NLR), and low platelet-to-lymphocyte ratio (PLR) at baseline had significantly improved treatment failure (TTF) compared with those with low ALC, high NLR, and high PLR, respectively
We found that high ALC, low NLR, and high lymphocyte-to-monocyte ratio (LMR) were associated with longer overall survival (OS)
Summary
Paclitaxel plus bevacizumab (PB) therapy is an effective chemotherapeutic regimen for HER2-negative advanced breast cancer (ABC), predictive markers for its effectiveness remain undefined. Paclitaxel plus bevacizumab (PB) therapy increases the progression-free survival (PFS) and overall response rate (ORR) of patients with human epidermal growth factor receptor 2 (HER2)-negative advanced breast cancer (ABC)[1,2,3,4]. Studies have identified NLR and ALC as predictive markers for eribulin mesylate (eribulin) therapy for A BC18–20 and bevacizumab therapy for advanced non-small-cell lung cancer and metastatic colorectal cancer[21,22]. It is unclear whether these systemic immunity markers are useful as predictive markers for PB therapy in patients with ABC. Systemic immunity markers (ALC, NLR, PLR, and LMR) for predicting TTF and OS associated with PB therapy for HER2-negative ABC
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