Evidence map›Paper›PMID 42738414›Full record

ArticleCancers2026

On-Treatment NLR Dynamics During CDK4/6 Inhibition Are Associated with Overall Survival in Metastatic Breast Cancer.

Baha Sharaf, Zaid Omari, Qasem Alzoubi, Anas Zayed, Faris Tamimi, Ahmad Khater, Maen Hamad, Sharif Jehad, Nader Obeidat

Abstract read
In one paragraph

Article in Cancers, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

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0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Baha SharafKing Hussein Cancer Center, Amman 11941, Jordan.ORCID 0000-0003-4368-1224
Zaid OmariKing Hussein Cancer Center, Amman 11941, Jordan.ORCID 0000-0002-9987-7720
Qasem AlzoubiKing Hussein Cancer Center, Amman 11941, Jordan.
Anas ZayedKing Hussein Cancer Center, Amman 11941, Jordan.
Faris TamimiKing Hussein Cancer Center, Amman 11941, Jordan.ORCID 0000-0002-9337-6618
Ahmad KhaterKing Hussein Cancer Center, Amman 11941, Jordan.ORCID 0009-0004-2903-018X
Maen HamadKing Hussein Cancer Center, Amman 11941, Jordan.
Sharif JehadFaculty of Medicine, Yarmouk University, Irbid 21163, Jordan.
Nader ObeidatKing Hussein Cancer Center, Amman 11941, Jordan.ORCID 0009-0003-9749-3939

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND/

objectivesIn metastatic breast cancer (MBC) treated with CDK4/6 inhibitors, baseline neutrophil-to-lymphocyte ratio (NLR) is an established prognostic marker. On-treatment NLR dynamics have shown inconsistent associations with survival, and no prior study has applied a dominant-driver decomposition to classify patients by whether NLR change is neutrophil- or lymphocyte-driven.

methodsWe retrospectively analyzed 352 patients with HR+/HER2- MBC treated with ribociclib. Using paired neutrophil and lymphocyte counts at baseline and at approximately 12 weeks (before cycle 4), a log-linear decomposition classified patients into four NLR-trajectory phenotypes by the dominant driver of change. Associations with progression-free survival (PFS) and overall survival (OS) were assessed using a 4-month landmark approach with multivariable Cox models, with consistency evaluated across four thresholds, tertiles, and a continuous model. Secondarily, NLR change was compared across five response-trajectory groups.

resultsNLR trajectory was not associated with PFS in any specification (multivariable hazard ratio [HR] 1.15 per standard deviation [SD], 95% CI 0.97-1.37,

conclusionsOn-treatment NLR trajectory is a correlate of OS, independent of PFS, dose-limiting neutropenia, and dose reduction, in ribociclib-treated MBC, distinct from direct tumor control. Prospective validation is warranted.

Indexed as

biomarkerCDK4/6 inhibitorlandmark analysismetastatic breast cancerneutrophil-to-lymphocyte ratioribociclibtumor microenvironment

Identifiers

PMID42738414
PMCPMC13565387

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.