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Objective: There are some studies about the significance of the peripheral blood parameters in breast cancer. However, there is very few studies about prognostic importance of peripheral blood parameters in human epidermal growth factor-2 receptor (Her-2) positive breast cancer. We aimed to evaluate whether prognostic significance of peripheral blood parameters in patients Her-2 positive metastatic breast cancer with treated Pertuzumab, Trastuzumab, Docetaxel (PTD)
Material and Methods: We included 56 patients with Her-2 positive metastatic breast cancer patients who were treated with PTD. We recorded patients' clinical,demographic features and we obtained peripheral blood parameters such as neutrophil-lymphocyte ratio (NLR), red blood cell distribution (RDW), mean platelet volume (MPV), lymphocyte, neutrophil after the sixth cycle of the treatment and before the treatment. We separated the patients into two groups depending on the progression status. Progression-free survival was analyzed by Kaplan-Meier statistical analysis.
Results: Patients mean age was 50.7. Progression was detected in 34 patients. When we explored and compared hemogram parameters in the groups before the treatment, there wasn’t statistically any significant difference between these parameters such as neutrophil, lymphocyte, neutrophil to lymphocyte ratio, mean platelet volume, red blood cell width. In the progressive group;,while pretreatment NLR was 3.83, it was detected 2.72 after six cycle treatment and difference was meaningful ( p: 0.043). The pretreamtent MPV was 8.63, and It was 8.15 after six cycle treatment, and difference between these counts was statistically important (p: 0.006). PFS was 18.0 months in the study group.
Conclusion: Peripheral blood parameters were not statistically significant in both group comparisons. In the progression group, the difference between NLR and MPV count was statistically significant after the sixth cycle of the treatment and before the treatment.
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Martin M, Lopez-Tarruella S. Emerging therapeutic options for HER2-positive breast Cancer. Am Soc Clin Oncol Educ Book/ASCO Am Soc Clin Oncol Meet. 2016;35:64–70. DOI: https://doi.org/10.1200/EDBK_159167
Araki K, Fukada I, Yanagi H, Kobayashi K, Shibayama T, Horii R, et al. First report of eribulin in combination with pertuzumab and trastuzumab for advanced HER2-positive breast cancer. Breast. 2017;35:78–84 DOI: https://doi.org/10.1016/j.breast.2017.06.015
Muntasell A, Cabo M, Servitja S, Tusquets I, Martinez-Garcia M, Rovira A, et al. Interplay between natural killer cells and anti-HER2 antibodies: perspectives for breast Cancer immunotherapy. Front Immunol. 2017;8:1544. DOI: https://doi.org/10.3389/fimmu.2017.01544
Ma JP, Wang Z, Lin JW, Wu KM, Chen JH, et al. Neutrophil-lymphocyte ratio as a prognostic factor in gastric cancer. Zhonghua Wei Chang Wai Ke Za Zhi 2011;14: 944-7.
Keizman D, Ish-Shalom M, Huang P, Eisenberger MA, Pili R, Hammers H, et al. The association of pre-treatment neutrophil to lymphocyte ratio with response rate, progression free survival and overall survival of patients treated with sunitinib for metastatic renal cell carcinoma. Eur J Cancer 2012;48: 202-8. DOI: https://doi.org/10.1016/j.ejca.2011.09.001
Wolff AC, Hammond ME, Schwartz JN, Hagerty KL, Allred DC, Cote RJ, et al. American Society of Clinical Oncology/College of American Pathologists guideline recommendations for human epidermal growth factor receptor 2 testing in breast cancer. J Clin Oncol 2007; 25:118-45. DOI: https://doi.org/10.1200/JCO.2006.09.2775
Ross JS, Slodkowska EA, Symmans WF, Pusztai L, Ravdin PM, Hortobagyi GN. The HER-2 receptor and breast cancer: ten years of targeted anti-HER-2 therapy and personalized medicine. Oncologist. 2009;14:320–68. DOI: https://doi.org/10.1634/theoncologist.2008-0230
Baselga J, Cortes J, Kim, SB, Ah-Im, S, Hegg R, Im YH, et al. Pertuzumab plus trastuzumab plus docetaxel for metastatic breast cancer. N Engl J Med 2011; 366 (2):109–19. DOI: https://doi.org/10.1056/NEJMoa1113216
Esin E, Oksuzoglu B, Bilici A, Cicin I, Kostek O, Kaplan MA, et al. Pertuzumab, trastuzumab and taxane-based treatment for visceral organ metastatic, trastuzumab-naïve breast cancer: real-life practice outcomes Cancer Chemother Pharmacol 2019 ;83(1):131-43. DOI: https://doi.org/10.1007/s00280-018-3712-7
Araki K Yoshinori I , Ippei F , Kokoro K , Yoshimasa M , Michiko I, et al. Predictive impact of absolute lymphocyte counts for progression-free survival in human epidermal growth factor receptor 2-positive advanced breast cancer treated with pertuzumab and trastuzumab plus eribulin or nab-paclitaxel BMC Cancer (2018) 18:982. DOI: https://doi.org/10.1186/s12885-018-4888-2
Debu Trıpathy, Adam Brufsky, Melody Cobleıgh, Mohammad Jahanzeb, Peter A Kaufman, Gınny Mason, et al. De Novo Versus Recurrent HER2-Positive Metastatic Breast Cancer: Patient Characteristics, Treatment, and Survival from the SystHERs Registry The Oncologist 2020;25:214–22. DOI: https://doi.org/10.1634/theoncologist.2019-0446
Carlson RW, Moench SJ, Hammond ME, Perez EA, Burstein HJ, Allred DC et al. HER2 testing in breast cancer: NCCN Task Force report and recommendations. J Natl Compr Canc Netw 2006;4: Suppl 3:1-22. DOI: https://doi.org/10.6004/jnccn.2006.2003
Cardoso F, Senkus E, Costa A, Papadopoulos E, Aapro M, Andre F et al. 4th ESO–ESMO international consensus guidelines for advanced breast cancer (ABC 4). Ann. Oncol. 2018; 29:1634–57 DOI: https://doi.org/10.1093/annonc/mdy192
Coussens LM, Werb Z. Inflammation and cancer. Nature 2002;420:860-7. DOI: https://doi.org/10.1038/nature01322
Nakano K, Hosoda M, Yamamoto M, Yamashita H. Prognostic significance of pre-treatment neutrophil:lymphocyte ratio in Japanese patients with breast cancer. Anticancer Res 2014;34:3819-24.
Arife Ulas , Nilufer Avci , Tugba Kos , Erdem Cubukcu, Omer Fatih Olmez, Nilufer Bulut, et al. Are neutrophil / lymphocyte ratio and platelet / lymphocyte ratio associated with prognosis in patients with HER2- positive early breast cancer receiving adjuvant trastuzumab? JBUON 2015; 20: 714-22.