Valuable predictive power of prognostic nutritional index in metastatic breast cancer patients treated with CDK4/6 inhibitors
Japanese Journal of Clinical Oncology, cilt.55, sa.6, ss.578-587, 2025 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 55 Sayı: 6
- Basım Tarihi: 2025
- Doi Numarası: 10.1093/jjco/hyaf036
- Dergi Adı: Japanese Journal of Clinical Oncology
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, EMBASE
- Sayfa Sayıları: ss.578-587
- Anahtar Kelimeler: prognostic nutritional index, breast cancer, CDK4/6 inhibitor, prognosis
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Aims and Objectives The prognostic value of nutritional status in HR+/HER2- metastatic breast cancer (mBC) patients treated with CDK4/6 inhibitors (CDK4/6is) and endocrine therapy (ET) is unclear. Methods/Materials The effect of PNI values before starting CDK 4/6i on patient prognosis was retrospectively analyzed. Results A total of 431 patients were evaluated. After 35.7 months of follow-up, the median overall survival (mOS) was 46.3 months (95% CI, 29.7-62.8). The PNI-low group had decreased progression-free survival compared to the PNI-high group [16.6 vs. 30.5 months; univariate HR = 1.640, 95% confidence interval (CI): 1.281-2.099, P <. 001]. The PNI-low group's mOS was noticeably shorter than the PNI-high group (35.0 months vs. not reached; multivariate-adjusted HR: 2.082, 95% CI: 1.398-3.102, P <. 001). When stratified by CDK4/6i line: In patients using CDK4/6i as the first line, mPFS for the PNI-low and PNI-high group was 24.6 vs. 35.6 months (P =. 026), and survival probabilities at 24, 36, and 48 months in the PNI-low and PNI-high groups were 75%, 62%, 57%, and 88%, 80%, and 72%, respectively (P =. 002). In patients using CDK4/6i as the second line and after, mPFS was 8.2 vs.12.0 months (P =. 014), and mOS was 18.6 vs. 39.6 months (P =. 001) for the PNI-low and PNI-high group, respectively. The ORR and DCR were significantly lower in the low-PNI group than in the high-PNI group (P =. 018 and P =. 017, respectively). The incidence of grade 3-4 side effects due to CDK4/6is (39.8% vs. 30.7%, P =. 046) was significantly greater in the PNI-low group than in the PNI-high group. Conclusions This study's results suggest that PNI is an easily measured and reliable indicator of prognosis in mBC patients treated with CDK4/6i and ET.