{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T18:43:45Z","timestamp":1776278625730,"version":"3.50.1"},"reference-count":39,"publisher":"Wiley","issue":"21","license":[{"start":{"date-parts":[[2021,9,30]],"date-time":"2021-09-30T00:00:00Z","timestamp":1632960000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Combination CDK4\/6 inhibitor and endocrine therapy has been shown to significantly improve progression\u2010free survival (PFS) in patients with hormone receptor (HR)\u2010positive, HER2\u2010negative metastatic breast cancer (mBC). The aim of this retrospective study was to evaluate the real\u2010world benefit of first\u2010line combination therapy in this cohort and to correlate treatment efficacy with neutropenia, a common toxicity of CDK4\/6 inhibitors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study included HR\u2010positive, HER2\u2010negative advanced or mBC patients who were treated with palbociclib plus endocrine therapy, mainly letrozole, between 1 January 2015 and 1 March 2018. Progression\u2010free survival (PFS) was determined using Kaplan\u2013Meier analysis. The predictive value of absolute neutrophil count (ANC) and neutrophil\u2010to\u2010lymphocyte ratio (NLR) for PFS were explored using Cox regression models. Both ANC and NLR were used as a time\u2010dependent variable.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 165 patients were included with median PFS of 24.19\u00a0months (95% CI 18.93\u2013NR). Median PFS for patients with bone\u2010only metastases (<jats:italic>n<\/jats:italic>\u00a0=\u00a054) was not reached (95% CI 18.21\u2013NR). Among patients with all other metastases (<jats:italic>n<\/jats:italic>\u00a0=\u00a0111), median PFS was 24.19\u00a0months (95% CI 16.33\u201333.82). Lower ANC was correlated with decreased risk of progression (HR 0.84, 95% CI 0.71\u20130.97, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.008). There was no significant association between NLR and the risk of disease progression (HR 1.07, 95% CI 0.97\u20131.18, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.203).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The effectiveness of palbociclib and endocrine therapy in the treatment of HR\u2010positive, HER2\u2010negative mBC in the real\u2010world setting is similar to the efficacy reported in the PALOMA\u20102 trial. Patients with lower neutrophil count may have a lower risk of early disease progression.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.4295","type":"journal-article","created":{"date-parts":[[2021,9,30]],"date-time":"2021-09-30T16:20:04Z","timestamp":1633018804000},"page":"7665-7672","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Real\u2010world benefit of combination palbociclib and endocrine therapy for metastatic breast cancer and correlation with neutropenia"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9915-6974","authenticated-orcid":false,"given":"James","family":"Sun","sequence":"first","affiliation":[{"name":"Department of Breast Oncology Moffitt Cancer Center Tampa Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaojun","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department of Breast Oncology Moffitt Cancer Center Tampa Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junjie","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Pharmacotherapy University of Utah Salt Lake City Utah USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weihong","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Breast Oncology Moffitt Cancer Center Tampa Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hyo S.","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Breast Oncology Moffitt Cancer Center Tampa Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6644-2264","authenticated-orcid":false,"given":"Hatem H.","family":"Soliman","sequence":"additional","affiliation":[{"name":"Department of Breast Oncology Moffitt Cancer Center Tampa Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Loretta S.","family":"Loftus","sequence":"additional","affiliation":[{"name":"Department of Breast Oncology Moffitt Cancer Center Tampa Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ricardo L. B.","family":"Costa","sequence":"additional","affiliation":[{"name":"Department of Breast Oncology Moffitt Cancer Center Tampa Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Avan J.","family":"Armaghani","sequence":"additional","affiliation":[{"name":"Department of Breast Oncology Moffitt Cancer Center Tampa Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aixa E.","family":"Soyano\u2010Muller","sequence":"additional","affiliation":[{"name":"Department of Breast Oncology Moffitt Cancer Center Tampa Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian J.","family":"Czerniecki","sequence":"additional","affiliation":[{"name":"Department of Breast Oncology Moffitt Cancer Center Tampa Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. Catherine","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Breast Oncology Moffitt Cancer Center Tampa Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John V.","family":"Kiluk","sequence":"additional","affiliation":[{"name":"Department of Breast Oncology Moffitt Cancer Center Tampa Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nazanin","family":"Khakpour","sequence":"additional","affiliation":[{"name":"Department of Breast Oncology Moffitt Cancer Center Tampa Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan J.","family":"Hoover","sequence":"additional","affiliation":[{"name":"Department of Breast Oncology Moffitt Cancer Center Tampa Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine","family":"Laronga","sequence":"additional","affiliation":[{"name":"Department of Breast Oncology Moffitt Cancer Center Tampa Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hung T.","family":"Khong","sequence":"additional","affiliation":[{"name":"Department of Breast Oncology Moffitt Cancer Center Tampa Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,9,30]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21583"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/dju055"},{"key":"e_1_2_10_4_1","unstructured":"National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology Breast Cancer Version 4.2020.2020."},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2016.67.1487"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2006.08.8054"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/dji250"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1607303"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1505270"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1810527"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41523-018-0097-z"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2017.73.7585"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1609709"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(18)30292-4"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2018.08.011"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/nri3625"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2011.177"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-11-0509"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(14)71159-3"},{"key":"e_1_2_10_20_1","article-title":"Progression\u2010free survival for real\u2010world use of palbociclib in hormone receptor\u2010positive metastatic breast cancer","author":"Wilkie J","year":"2019","journal-title":"Clin Breast Cancer"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2015.00471"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI37223"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1038\/nri2506"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00262-012-1294-5"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00018-013-1286-4"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-015-1204-2"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.4048\/jbc.2013.16.1.55"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-011-1814-0"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12032-012-0432-4"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13277-014-2282-5"},{"key":"e_1_2_10_31_1","unstructured":"KhongH.MCC 19591 real\u2010world benefit of combination palbociclib and endocrine therapy for metastatic breast cancer and correlation with neutropenia.2020. 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