Prediction of survival after eribulin chemotherapy for breast cancer by absolute lymphocyte counts and progression types

Abstract Background In the Response Evaluation Criteria for Solid Tumors (RECIST) diagnostic criteria, the concepts of progression by preexisting disease (PPL) and progression by new metastases (PNM) have been proposed to distinguish between the progression types of cancer refractory to treatment. A...

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Autores principales:	Tamami Morisaki, Shinichiro Kashiwagi, Yuka Asano, Wataru Goto, Koji Takada, Sae Ishihara, Masatsune Shibutani, Hiroaki Tanaka, Kosei Hirakawa, Masaichi Ohira
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Eribulin Breast cancer RECIST Prognostic marker Absolute lymphocyte counts Surgery RD1-811 Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/e54817fa42b646deb194c78a1cb4c184
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spelling	oai:doaj.org-article:e54817fa42b646deb194c78a1cb4c1842021-11-21T12:33:41ZPrediction of survival after eribulin chemotherapy for breast cancer by absolute lymphocyte counts and progression types10.1186/s12957-021-02441-w1477-7819https://doaj.org/article/e54817fa42b646deb194c78a1cb4c1842021-11-01T00:00:00Zhttps://doi.org/10.1186/s12957-021-02441-whttps://doaj.org/toc/1477-7819Abstract Background In the Response Evaluation Criteria for Solid Tumors (RECIST) diagnostic criteria, the concepts of progression by preexisting disease (PPL) and progression by new metastases (PNM) have been proposed to distinguish between the progression types of cancer refractory to treatment. According to the tumor biology of cancer progression forms, the “PPL” form indicates invasion, and the “PNM” form indicates metastasis. On the other hand, recent studies have focused on the clinical importance of inflammatory markers as indicators of the systemic tumor immune response. In particular, absolute lymphocyte count (ALC) is an indicator of the host’s immune response. Thus, we developed a new measure that combined progression form with ALC. In this study, we clinically validated the combined assessment of progression form and ALC in eribulin chemotherapy. Methods From August 2011 to April 2019, a total of 486 patients with locally advanced or metastatic breast cancer (MBC) underwent treatment. In this study, only 88 patients who underwent chemotherapy using eribulin were included. The antitumor effect was evaluated based on the RECIST criteria, version 1.1. To measure ALC, peripheral blood samples collected before eribulin treatment were used. The cut-off value for ALC in this study was 1500/μl, based on previous studies. Results The PPL group (71 patients, 80.7%) had significantly longer progression-free survival (PFS) (p = 0.022, log-rank) and overall survival (OS) (p < 0.001, log-rank) than the PNM group (17 patients, 19.3%). In the 51 patients with ALC < 1500/μl, the PPL group had a significantly better prognosis than the PNM group (PFS: p = 0.035, OS: p < 0.001, log-rank, respectively). On the other hand, in the 37 patients with ALC ≥ 1500/μl, the PPL group had a better OS compared with the PNM group (p = 0.055, log-rank), but there was no significant difference in PFS between the two groups (p = 0.541, log-rank). Furthermore, multivariate analysis that validated the effect of OS showed that high ORR and “high-ALC and PPL” were factors for a good prognosis (p < 0.001, HR = 0.321; p = 0.036, HR = 0.290). Conclusions The progression form of PNM had a worse prognosis than PPL in patients treated with eribulin. In breast cancer patients with eribulin chemotherapy, good systemic immune status, such as ALC ≥ 1500/μl, was associated with less progression, particularly metastasis, and better prognosis. Furthermore, the biomarker “high-ALC (ALC ≥ 1500/μl) and PPL” was particularly useful as a prognostic marker following eribulin chemotherapy.Tamami MorisakiShinichiro KashiwagiYuka AsanoWataru GotoKoji TakadaSae IshiharaMasatsune ShibutaniHiroaki TanakaKosei HirakawaMasaichi OhiraBMCarticleEribulinBreast cancerRECISTPrognostic markerAbsolute lymphocyte countsSurgeryRD1-811Neoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENWorld Journal of Surgical Oncology, Vol 19, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Eribulin Breast cancer RECIST Prognostic marker Absolute lymphocyte counts Surgery RD1-811 Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	Eribulin Breast cancer RECIST Prognostic marker Absolute lymphocyte counts Surgery RD1-811 Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Tamami Morisaki Shinichiro Kashiwagi Yuka Asano Wataru Goto Koji Takada Sae Ishihara Masatsune Shibutani Hiroaki Tanaka Kosei Hirakawa Masaichi Ohira Prediction of survival after eribulin chemotherapy for breast cancer by absolute lymphocyte counts and progression types
description	Abstract Background In the Response Evaluation Criteria for Solid Tumors (RECIST) diagnostic criteria, the concepts of progression by preexisting disease (PPL) and progression by new metastases (PNM) have been proposed to distinguish between the progression types of cancer refractory to treatment. According to the tumor biology of cancer progression forms, the “PPL” form indicates invasion, and the “PNM” form indicates metastasis. On the other hand, recent studies have focused on the clinical importance of inflammatory markers as indicators of the systemic tumor immune response. In particular, absolute lymphocyte count (ALC) is an indicator of the host’s immune response. Thus, we developed a new measure that combined progression form with ALC. In this study, we clinically validated the combined assessment of progression form and ALC in eribulin chemotherapy. Methods From August 2011 to April 2019, a total of 486 patients with locally advanced or metastatic breast cancer (MBC) underwent treatment. In this study, only 88 patients who underwent chemotherapy using eribulin were included. The antitumor effect was evaluated based on the RECIST criteria, version 1.1. To measure ALC, peripheral blood samples collected before eribulin treatment were used. The cut-off value for ALC in this study was 1500/μl, based on previous studies. Results The PPL group (71 patients, 80.7%) had significantly longer progression-free survival (PFS) (p = 0.022, log-rank) and overall survival (OS) (p < 0.001, log-rank) than the PNM group (17 patients, 19.3%). In the 51 patients with ALC < 1500/μl, the PPL group had a significantly better prognosis than the PNM group (PFS: p = 0.035, OS: p < 0.001, log-rank, respectively). On the other hand, in the 37 patients with ALC ≥ 1500/μl, the PPL group had a better OS compared with the PNM group (p = 0.055, log-rank), but there was no significant difference in PFS between the two groups (p = 0.541, log-rank). Furthermore, multivariate analysis that validated the effect of OS showed that high ORR and “high-ALC and PPL” were factors for a good prognosis (p < 0.001, HR = 0.321; p = 0.036, HR = 0.290). Conclusions The progression form of PNM had a worse prognosis than PPL in patients treated with eribulin. In breast cancer patients with eribulin chemotherapy, good systemic immune status, such as ALC ≥ 1500/μl, was associated with less progression, particularly metastasis, and better prognosis. Furthermore, the biomarker “high-ALC (ALC ≥ 1500/μl) and PPL” was particularly useful as a prognostic marker following eribulin chemotherapy.
format	article
author	Tamami Morisaki Shinichiro Kashiwagi Yuka Asano Wataru Goto Koji Takada Sae Ishihara Masatsune Shibutani Hiroaki Tanaka Kosei Hirakawa Masaichi Ohira
author_facet	Tamami Morisaki Shinichiro Kashiwagi Yuka Asano Wataru Goto Koji Takada Sae Ishihara Masatsune Shibutani Hiroaki Tanaka Kosei Hirakawa Masaichi Ohira
author_sort	Tamami Morisaki
title	Prediction of survival after eribulin chemotherapy for breast cancer by absolute lymphocyte counts and progression types
title_short	Prediction of survival after eribulin chemotherapy for breast cancer by absolute lymphocyte counts and progression types
title_full	Prediction of survival after eribulin chemotherapy for breast cancer by absolute lymphocyte counts and progression types
title_fullStr	Prediction of survival after eribulin chemotherapy for breast cancer by absolute lymphocyte counts and progression types
title_full_unstemmed	Prediction of survival after eribulin chemotherapy for breast cancer by absolute lymphocyte counts and progression types
title_sort	prediction of survival after eribulin chemotherapy for breast cancer by absolute lymphocyte counts and progression types
publisher	BMC
publishDate	2021
url	https://doaj.org/article/e54817fa42b646deb194c78a1cb4c184
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Prediction of survival after eribulin chemotherapy for breast cancer by absolute lymphocyte counts and progression types

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