ArticleBreast (Edinburgh, Scotland)2025
Baseline neutrophil-lymphocyte ratio (NLR) predicts toxicity and survival in HR+/HER-2 breast cancer patients treated with CDK4/6 inhibitors.
Article in Breast (Edinburgh, Scotland), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Real-world efficacy and safety of CDK4/6 inhibitors plus endocrine therapy in HR+/HER2 - metastatic breast cancer: a single-institution experience.Journal of the Egyptian National Cancer Institute · 2026Article
- Pretreatment neutrophil-to-lymphocyte ratio (NLR) as a potential risk marker for febrile neutropenia (FN) in breast and ovarian cancer during first-cycle chemotherapy.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Article
- Predictive Role of Serum Inflammatory Markers in Metastatic Luminal A/B Breast Cancers Receiving CDK-4/6 Inhibitors Therapy.Immunity, inflammation and disease · 2026Article
- Review
- The prognostic value of peripheral blood inflammatory markers in patients with HER2-positive metastatic breast cancer treated with pyrotinib.Frontiers in oncology · 2026Article
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5 authors.
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Abstract
The neutrophil-to-lymphocyte ratio (NLR) is a marker of systemic inflammation that has been associated with prognosis in various malignancies. Its role in predicting toxicity and survival in patients with hormone receptor-positive, human epidermal growth factor receptor 2-negative (HR+/HER2-) metastatic breast cancer treated with cyclin-dependent kinase 4/6 (CDK4/6) inhibitors remains unclear.
methodsThis retrospective cohort study included 2218 patients with HR+/HER2- metastatic breast cancer treated with palbociclib or ribociclib between 2017 and 2024, using data from Israel's largest health maintenance organization. We compared baseline NLR values between patients who developed grade 4 neutropenia (absolute neutrophil count <0.5 × 10
resultsPatients with grade 4 neutropenia had significantly higher baseline NLR values compared to those with higher neutrophil counts. The effect size was large in all comparisons. Patients with an NLR of ≥2.5 had a shorter median progression-free survival (PFS) than those with an NLR of <2.5. Hepatotoxicity was more frequently observed in patients with NLR <2.5, while the incidence of dermatologic adverse events was similar across groups.
conclusionsElevated baseline NLR is associated with an increased risk of severe neutropenia and shorter progression-free survival in patients treated with CDK4/6 inhibitors. These findings highlight a potential link between systemic inflammation and treatment outcomes, suggesting that NLR may be a valuable predictive biomarker in this setting.
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