The Pan-Immune-Inflammation-Value Predicts the Survival of Patients with Estrogen Receptor-Positive,Human Epidermal Growth Factor Receptor 2 (HER2)—Negative Metastatic Breast Cancer Breast Cancer Treated with CDK4/6 inhibitors

Pan-Immune-Inflammation-Value in Metastatic Breast Cancer Breast Cancer Treated with CDK4/6 inhibitors

Abstract

Background: To define the prognostic value of pan immune-inflammation value (PIV) in patients with Estrogen receptor (ER)-positive, Human epidermal growth factor receptor  2(HER2)- negative metastatic breast cancer.

Methods: We retrospectively evaluated the prognostic impact of PIV on the survival of patients with ER+, HER2- metastatic breast cancer receiving CDK4/6 inhibitors. The cut-off value of CRP/alb, N/L, L/M, PLT/L, SII, and PIV is determined by using the receiver operating characteristic(ROC) analysis. Progression-free survival (PFS) comparisons of palbociclib and ribociclib treatments, and CRP/albumin, neutrophil/lymphocyte ratio, systemic immune inflammation index, and PIV were performed using Kaplan-Meier curves and median survival times. PIV was calculated as neutrophil x platelet x monocyte /lymphocyte count (10⁹/L).

Results: Ninety-one patients were included in this study. The patients' mean age was 58.4±11.7 years. At a median follow-up of 48 months, 11%(10) of patients died. 53.8%(49) of patients had the metastatic disease when they were diagnosed. 87.9%(80) were menopausal, and 39.6%(36) received ribociclib, 60.4%(55) palbociclib. The cutoff value of PIV 476.5 is calculated using the receiver operating characteristic(ROC) analysis. The Cox regression analysis for PFS showed that PIV (HR:4.68;p=0.022) and drugs combined with CDK4/6 (HR:4.68;p=0.022) were the only independent prognostic markers for PFS. Median progression-free difference was not significantly significant between ribociclib and palbociclib groups (27.9 vs 25.5 months respectively;%95 CI,25.9-29;p=0.654).

Conclusions: PIV is a simple and inexpensive, easily calculated marker to predict the survival of patients with ER-positive, HER2-negative metastatic breast cancer. This technique can assist physicians in putting tailored and focused treatment plans in place. Between ribociclib and palbociclib, there is no statistically significant difference in PFS.