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Absolute lymphocyte count as a biomarker for best supportive care transition in metastatic breast cancer
  1. Yoshiya Horimoto1,2,
  2. Hikari Jimbo1,
  3. Yumiko Ishizuka1,
  4. Noriko Nogami1,3,
  5. Goro Kutomi1 and
  6. Junichiro Watanabe1
  1. 1Breast Oncology, Juntendo University Faculty of Medicine, Bunkyo-ku, Tokyo, Japan
  2. 2Breast Surgery and Oncology, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
  3. 3Palliative Medicine, Juntendo University Faculty of Medicine, Bunkyo-ku, Tokyo, Japan
  1. Correspondence to Dr Yoshiya Horimoto, Tokyo Medical University, Shinjuku-ku, Japan; horimoto.yoshiya.4m{at}tokyo-med.ac.jp

Abstract

Objectives Time is crucial for patients with metastatic breast cancer (MBC), and clinicians are expected to determine the optimal timing for best supportive care (BSC) transition but no evident marker has been established. We recently revealed that absolute lymphocyte count (ALC) was a prognostic marker for patients with MBC. Thus, we investigated whether ALC could be an indicator of the best timing for the BSC transition.

Methods 101 patients with MBC were retrospectively investigated, and the relationship between clinicopathological factors, including ALC, and the duration of the last treatment was analysed.

Results Mean ALC significantly gradually decreased during the last three systemic treatments towards BSC transition. Patients of younger age, with special histology type, hormone receptor-positive tumours and low ALC at the start of the last treatment had significantly shorter time-to-treatment-termination (TTT) for the last treatment. When ALC was classified into low and high, the mean TTT of the last treatment in the ALC-low group was significantly shorter (16.4 weeks) compared with that in the ALC-high group (30.2 weeks; p=0.004).

Conclusions Our data suggest that ALC values, which decrease as MBC progresses, could serve as a potential indicator for determining the optimal timing of BSC transition.

  • Transitional care
  • Prognosis
  • Clinical decisions
  • Breast
  • Advance Care Planning

https://doi.org/10.1136/spcare-2024-004989

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    Footnotes

    • Contributors YH, HJ and JW designed this study. YH, HJ, YI and NN collected clinical data. YH conducted data analysis and statistics. YH drafted the original manuscript and GK and JW substantively revised it. All authors have read and approved the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.