Hormon reseptör pozitif, HER-2 negatif metastatik meme kanserli hastalarda CDK4/6 inhibitörü tedavisi öncesi sistemik immün inflamasyon indekslerinin ve prognostik nutrisyonel indeksin prognostik önemi

Yıl 2023, Cilt: 16 Sayı: 4, 682 - 695, 01.10.2023

Burçin ÇAKAN DEMİREL Arzu YAREN Atike Gökçen DEMİRAY Burcu YAPAR TAŞKÖYLÜ Tolga DOĞAN Melek ÖZDEMİR Taliha GÜÇLÜ KANTAR Canan KARAN Serkan DEĞİRMENCİOĞLU Gamze GOKOZ DOGU

https://doi.org/10.31362/patd.1268419

Öz

Amaç: Sistemik inflamatuvar indeksler ve Prognostik nutrisyonel indeks birçok tümör tipinde kötü prognoz ile ilişkilidir. Çalışmamızda hormon reseptörü pozitif HER2 negatif metastatik meme kanserli hastalarda CDK4/6 inhibitörü tedavisi öncesinde sistemik inflamatuar indeksi, prognostik nutrisyonel indeks, Nötrofil/Lenfosit oranı, Platelet/Lenfosit oranı, Lenfosit Monosit Oranı, C-reaktif protein/albümin oranı, sistemik inflamatuar yanıt indeksi gibi belirteçlerin progresyonsuz sağkalım ve tüm sağkalım üzerine etkisini araştırdık.
Gereç ve yöntem: Ocak 2018-Mayıs 2022 tarihleri arasında Tıbbi Onkoloji polikliniğe başvuran hormon reseptörü pozitif HER2 negatif metastatik meme kanserli hastalarda CDK4/6 inhibitörü tedavisi öncesi hastaların verileri retrospektif olarak incelendi. Bu belirteçlerin progresyonsuz sağkalım ve total sağkalım üzerine etkisi araştırıldı.
Bulgular: Çalışmaya 79 hasta dahil edildi. Hastaların ortanca yaşları 53 (aralık 26-80 yıl) idi. Yetmiş hasta (%88,6) postmenopozaldı. Hastaların 68’inin (%86,1) performans skoru 0‘dı. Adjuvan endokrin tedavi sırasında 10 hastanın (%12,7) metastazı gelişti. PSK’yi etkileyen faktörler; yaş <50 (p=0,061), adjuvan endokrin tedavi sırasında metastaz gelişmesi (p=0,09) ve C-reaktif protein/albümin oranı (p=0,019) iken; TSK’ı etkileyen faktörler; yaş <50 (p=0,069) ve adjuvan endokrin tedavi sırasında metastaz gelişmesi (p=0,012) olarak bulundu.
Sonuç: Hormon reseptörü+/HER2 – metastatik meme kanserli hastalarda CDK4/6 inhibitörü tedavisinden önce hastaların sistemik inflamatuvar indeksleri ve prognostik nutrisyonel indeksi progresyonsuz sağkalımı etkilemektedir. Ayrıca hastalarda adjuvan endokrin tedavi sırasında metastaz gelişmesi, progesteron reseptör yüzdesi ve 50 yaşın altı olması tüm sağkalım için olumsuz prognostik faktörler olarak değerlendirildi.

Anahtar Kelimeler

HR+/Her2- meme kanseri, CDK4/6 inhibitörü, sistemik inflamatuar indeksler, prognostik nutrisyonel indeks, PSK

Prognostic significance of systemic immune inflammation indices and prognostic nutritional index before CDK4/6 inhibitor therapy in hormone receptor positive, HER2 negative metastatic breast cancer patients

Öz

Purpose: As systemic inflammatory indices and prognostic nutritional index are associated with poor prognosis in many tumor types, the goal of the present study was to ascertain their effect along with the neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, lymphocyte/monocyte ratio, C-reactive protein/albumin ratio, and systemic inflammatory response index on the progression-free survival (PFS) and overall survival (OS) of hormone receptor-positive HER2-negative (HR+/HER2−) metastatic breast cancer patients before CDK4/6 inhibitor treatment.
Materials and methods: The medical records of 79 patients with HR+/HER2− metastatic breast cancer who presented at the Medical Oncology Outpatient Clinic between January 2018 and May 2022 were retrospectively analyzed to gather relevant data measured before CDK4/6 inhibitor treatment in order to establish the effect of key markers on their PFS and OS.
Results: The median age of the participating patients, 70 (88.6%) of whom were postmenopausal, was 53 years (range 26-80 years). While 68 patients (86.1%) had a 0 performance score, 10 (12.7%) developed metastases during adjuvant endocrine therapy. Factors affecting PFS were age <50 (p=0.061), metastasis development during adjuvant endocrine therapy (p=0.09) and C-reactive protein/albumin ratio (p=0.019), while OS was primarily influenced by age <50 (p=0.069) and metastasis development during adjuvant endocrine therapy (p=0.012).
Conclusion: In the examined HR+/HER2− metastatic breast cancer patients, systemic inflammatory indices and prognostic nutritional index before CDK4/6 inhibitor treatment affected PFS. In addition, metastasis development during adjuvant endocrine therapy, progesterone receptor percentage, and age below 50 years emerged as prognostic factors for shorter overall survival.

Anahtar Kelimeler

HR+/HER2− metastatic breast cancer, CDK4/6 inhibitors, systemic inflammatory indices, prognostic nutritional index, PFS

Kaynakça

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