Predictive Value of Lymphocyte-Related Blood Parameters of before Ado-Trastuzumab Emtansin Treatment in Breast Cancer

Abstract

Objective: Ado-Trastuzumab Emtansine ( TDM1) has been used in the treatment of HER2 metastatic breast cancer after FDA approval as an antibody-drug conjugate. Some markers may be predictive for clinician in the management of this TDM1 therapy. There is a need for simple and cost-effective markers to show the treatment response. The primary aim of this study is to establish a correlation between progression free survival and pre-treatment hematological inflammatory parameters [absolute lymphocyte count (ALC), neutrophil-to-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR)] in advance breast cancer. Methods: Forty-one female patients with metastatic HER-2 positive breast cancer who received TDM-1 between 2016 and 2021 were evaluated retrospectively. NLR and PLR were calculated with the values of neutrophils, lymphocytes, and trombocytes in complete blood count at the time of diagnosis. The cut off values of NLR and PLR were determined using receiver operating characteristic (ROC) curve analysis. Overall survival (OS) and progression free survival (PFS) associated with prior treatment NLR, PLR, ALC were performed by Kaplan-Meier method. Results: Median age was 49.5 years years (26-76).Patients divided into 2 groups according to NLR cut-off and TLR cutoff values as NLR/TLR high and low groups. The cut-off values of NLR and TLR were 144.0, and 2.74, respectively. ALC divided into 2 groups. There was no significant difference in OS between NLR ,PLR,ALC (high/low) groups. (p=0.04, 0.15, 0.53 respectively). There was only significant difference in PFS (high/low) groups.(p=0.81, 0.99, 0.96 respectively). Conclusions: The predictive value of pre-treatment only NLR on the therapeutic potential in patients with metastatic breast cancer treated with TDM1.