Współczesna Onkologia

Baseline values and dynamic changes of inflammatory indices are not prognostic for progressionfree survival in first-line pembrolizumab plus chemotherapy for programmed death-ligand 1-positive advanced triple-negative breast cancer: a Polish multicenter cohort study

Małgorzata Pieniążek 1
,
Karolina Winsko-Szczęsnowicz 2
,
Aleksandra Konieczna 3
,
Katarzyna Świderska 4
,
Iwona Danielewicz 5
,
Roman Dubiański 6
,
Agnieszka Roman 7
,
Justyna Żubrowska 8
,
Anna Górniak 3
,
Jakub Wronowicz 9
,
Bogumiła Czartoryska-Arłukowicz 2
,
Michał Jarząb 4
,
Aleksandra Łacko 1
,
Renata Pacholczak-Madej 10, 11
,
Mirosława Püsküllüoğlu 12

  1. Lower Silesian Comprehensive Cancer Center, Wroclaw Medical University, Wroclaw, Poland

  2. Maria Sklodowska-Curie Bialystok Oncology Center, Bialystok, Poland

  3. Department of Breast Cancer and Reconstructive Surgery, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland

  4. Breast Cancer Unit, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland

  5. Department of Clinical Oncology, Maritime Hospital in Gdynia, Gdynia, Poland

  6. West Pomeranian Oncology Center, Szczecin, Poland

  7. Department of Clinical Oncology, Ludwik Rydygier Hospital, Cracow, Poland

  8. Department of Clinical Oncology, Holy Cross Cancer Centre, Kielce, Poland

  9. Statistical Analysis Centre, Wroclaw Medical University, Wroclaw, Poland

  10. Department of Gynaecological Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch, Cracow, Poland

  11. Department of Anatomy, Jagiellonian University Medical College, Cracow, Poland

  12. Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch, Cracow, Poland

Contemp Oncol (Pozn) 2026; 30 (3)

DOI: https://doi.org/10.5114/wo.2026.165963
Data publikacji online: 2026/10/26
Article files
Baseline values.pdf Baseline values - Supplementary.pdf
  1. Zagami P, Carey LA. Triple negative breast cancer: pitfalls and progress. NPJ Breast Cancer 2022; 20: 95.
  2. Rosińska M, Dubiański R, Konieczna A, Poleszczuk J, Pawlik H, Nowecki ZI, et al. Retrospective observational study to determine the epidemiology and treatment patterns of patients with triple-negative breast cancer. Cancers (Basel) 2024; 16: 1087.
  3. Yin L, Duan JJ, Bian XW, Yu SC. Triple-negative breast cancer molecular subtyping and treatment progress. Breast Cancer Res 2020; 22: 61.
  4. Mittendorf EA, Philips A V., Meric-Bernstam F, Qiao N, Wu Y, Harrington S, et al. PD-L1 expression in triple-negative breast cancer. Cancer Immunol Res 2014; 2: 361-370
  5. Winsko-Szczęsnowicz K, Pieniążek M, Polakiewicz-Gilowska A, Kubeczko M, Holánek M, Malejčíková M, et al. Combined positive score status in metastatic triple-negative breast cancer patients treated with sacituzumab govitecan: associated clinical characteristics and testing patterns in a Central European cohort. Clin Translat Oncol 2026; 28: 2665-2674.
  6. Cortes J, Rugo HS, Cescon DW, Im SA, Yusof MM, Gallardo C, et al. Pembrolizumab plus chemotherapy in advanced triple-negative breast cancer. N Engl J Med 2022; 387: 217-226.
  7. Schmid P, Adams S, Rugo HS, Schneeweiss A, Barrios CH, Iwata H, et al. Atezolizumab and nab-paclitaxel in advanced triple-negative breast cancer. N Engl J Med 2018; 379: 2108-2121.
  8. Tolaney SM, de Azambuja E, Kalinsky K, Loi S, Kim SB, Yam C, et al. Sacituzumab govitecan (SG) + pembrolizumab (pembro) vs chemo­therapy (chemo) + pembro in previously untreated PD-L1-positive advanced triple-negative breast cancer (TNBC): primary results from the randomized phase 3 ASCENT-04/ KEYNOTE-D19 study. J Clin Oncol 2026; 394: 354-366.
  9. Pacholczak-Madej R, Drobniak A, Grela-Wojewoda A, Calik J, Viegas NV, Tusień-Małecka D, et al. Prognostic significance of peripheral blood biomarkers in patients with advanced renal cell carcinoma treated with nivolumab and ipilimumab-a polish multicenter, observational study. Clin Exp Med 2025; 25: 45.
  10. Criscitiello C, Marra A, Morganti S, Zagami P, Viale G, Esposito A, et al. Pretreatment blood parameters predict efficacy from immunotherapy agents in early phase clinical trials. Oncologist 2020; 25: e1732-e1742.
  11. Sacdalan DB, Lucero JA, Sacdalan DL. Prognostic utility of baseline neutrophil-to-lymphocyte ratio in patients receiving immune checkpoint inhibitors: a review and meta-analysis. Onco Targets Ther 2018; 11: 955-965.
  12. Xu H, He A, Liu A, Tong WX, Cao D. Evaluation of the prognostic role of platelet-lymphocyte ratio in cancer patients treated with immune checkpoint inhibitors: a systematic review and meta- analysis. Int Immunopharmacol 2019: 105957.
  13. Gu X, Han X, Shen Y, Shi Y. Prognostic value of systemic inflammation response index in cancer patients treated with PD-1/PD-L1 immune checkpoint inhibitors: a meta-analysis. Ann Med 2024; 56: 2413415.
  14. Kaczmarek F, Marcinkowska-Gapińska A, Bartkowiak-Wieczorek J, Nowak M, Kmiecik M, Brzezińska K, et al. Blood-based biomarkers as predictive and prognostic factors in immunotherapy-treated patients with solid tumors-currents and perspectives. Cancers (Basel) 2025; 17: 2001.
  15. Veglia F, Sanseviero E, Gabrilovich DI. Myeloid-derived suppressor cells in the era of increasing myeloid cell diversity. Nat Rev Immunol 2021; 21: 485-498
  16. Felismino T, Martins L, Barroso M, Carvalho D, Brito A, Maccali C, et al. Neutrophil-to-lymphocyte ratio (NLR) as a predictive biomarker in advanced hepatocellular carcinoma treated with first-line immunotherapy. J Gastrointestinal Cancer 2025; 56: 175.
  17. Knetki-Wróblewska M, Grzywna A, Krawczyk P, Wojas-Krawczyk K, Chmielewska I, Jankowski T, et al. Prognostic significance of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in second-line immunotherapy for patients with non-small cell lung cancer. Transl Lung Cancer Res 2025; 14: 749-760.
  18. Shen Y, Wang J, Hua Q, Dong M. The predictive value of NLR, PLR, LMR, NPAR and D-Dimer on the efficacy and prognosis of first-line immunotherapy for extensive-stage small cell lung cancer. J Inflamm Res 2025; 18: 17211-17222.
  19. Tan S, Zheng Q, Zhang W, Zhou M, Xia C, Feng W. Prognostic value of inflammatory markers NLR, PLR, and LMR in gastric cancer patients treated with immune checkpoint inhibitors: a meta-analysis and systematic review. Front Immunol 2024; 15: 1408700.
  20. Tian BW, Yang YF, Yang CC, Yan LJ, Ding ZN, Liu H, et al. Systemic immune-inflammation index predicts prognosis of cancer immunotherapy: systemic review and meta-analysis. Immunotherapy 2022; 14: 1481-1496.
  21. Nakamoto S, Shien T, Itoh M, Yamamoto Y, Ohsumi S, Yoshitomi S, et al. Systemic immunity markers are associated with clinical outcomes of atezolizumab treatment in patients with triple-negative advanced breast cancer: a retrospective multicenter observational study. Clin Exp Med 2023; 23: 5129-5138.
  22. Zhang Z, Zhang Y, Liu C, Shao J, Chen Y, Zhu Y, et al. A real-world study of immune checkpoint inhibitors in advanced triple- negative breast cancer. Cancer Innov 2023; 2: 172-180.
  23. Li X, Zhang Y, Zhu C, Xu W, Hu X, Martínez DAS, et al. Circulating blood biomarkers correlated with the prognosis of advanced triple negative breast cancer. BMC Womens Health 2024; 24: 38.
  24. Pieniążek M, Konieczna A, Świderska K, Danielewicz I, Dubiański R, Winsko-Szczęsnowicz K, et al. First real-world experience with first-line pembrolizumab-based treatment for advanced triple- negative breast cancer in Poland: a multicenter analysis. Ann Oncol. Available from: https://www.annalsofoncology.org/article/S0923-7534(25)01982-9/fulltext (accessed: 03.02.2026).
  25. Pieniążek M, Konieczna A, Świderska K, Danielewicz I, Dubiański R, Winsko-Szczęsnowicz K, et al. First real-world experience with first-line pembrolizumab and chemotherapy treatment for advanced triple-negative breast cancer in Poland: safety analysis and first survival outcomes from a multicenter cohort. Oncol Clin Pract 2026; 22: 523.
  26. ESMO Guidance for Reporting Oncology Real-World Evidence (ESMO-GROW) | ESMO. Available from: https://www.esmo.org/scales-and-tools/esmo-guidance-for-reporting-oncology-real- world-evidence-esmo-grow (accessed: 19.10.2025).
  27. Cuschieri S. The STROBE guidelines. Saudi J Anaesth 2019; 13: S31-S34.
  28. Common Terminology Criteria for Adverse Events (CTCAE) Common Terminology Criteria for Adverse Events (CTCAE) v5.0. Available from: https://dctd.cancer.gov/research/ctep-trials/for-sites/adverse-events/ctcae-v5-5x7.pdf.
  29. Schmied L, Höglund P, Meinke S. Platelet-mediated protection of cancer cells from immune surveillance - possible implications for cancer immunotherapy. Front Immunol 2021; 12: 640578.
  30. Ménétrier-Caux C, Ray-Coquard I, Blay JY, Caux C. Lymphopenia in cancer patients and its effects on response to immunotherapy: an opportunity for combination with cytokines? J Immunother Cancer 2019; 7: 85.
  31. Alečković M, Li Z, Zhou N, Qiu X, Lulseged B, Foidart P, et al. Combination therapies to improve the efficacy of immunotherapy in triple-negative breast cancer. Mol Cancer Ther 2023; 22: 1304-1318.
  32. Reguera-Nuñez E, Xu P, Chow A, Man S, Hilberg F, Kerbel RS. Therapeutic impact of Nintedanib with paclitaxel and/or a PD-L1 antibody in preclinical models of orthotopic primary or metastatic triple negative breast cancer. J Exp Clin Cancer Res 2019; 38: 16.
  33. Cortes J, Lipatov O, Im SA, Goncalves A, Lee KS, Schmid P, et al. Association of potential biomarkers with clinical outcomes in metastatic triple-negative breast cancer treated with pembrolizumab or chemotherapy. NPJ Breast Cancer 2025; 11: 109.
  34. Henry NL, Somerfield MR, Dayao Z, Elias A, Kalinsky K, McSha- ne LM, et al (2022) Biomarkers for systemic therapy in metastatic breast cancer: ASCO Guideline Update. J Clin Oncol 2022; 40: 3205-3221.
  35. Valero C, Lee M, Hoen D, Weiss K, Kelly DW, Adusumilli PS, et al. Pretreatment neutrophil-to-lymphocyte ratio and mutational burden as biomarkers of tumor response to immune checkpoint inhibitors. Nat Commun 2021; 12: 729.
  36. Ethier JL, Desautels D, Templeton A, Shah PS, Amir E. Prognostic role of neutrophil-to-lymphocyte ratio in breast cancer: a systematic review and meta-analysis. Breast Cancer Res 2017; 19: 2.
  37. Keramati MR, Elyasinia F, Keramati MR, Rezaei S, Ashouri M, Parsaei R, et al. Neutrophil-lymphocyte ratio in different stages of breast cancer. Acta Med Iran 2017; 55: 228-232.
  38. Sun Y, Guan Y, Yu H, Zhang Y, Tao J, Zhang W, et al. Predictive model using systemic inflammation markers to assess neoadjuvant chemotherapy efficacy in breast cancer. Front Oncol 2025; 15: 1552802.
  39. Qian X, Tao Y, Chen H, Li X, Wang Y, Xu X, et al. Real-world evaluation of the efficacy of immune checkpoint inhibitors in the treatment of metastatic breast cancer. Oncol Lett 2024; 29: 29.
  40. Giovanardi F, Casartelli C, Di Cicilia R, Bologna A, Gasparini E, Moretti G, et al. Systemic inflammatory markers in neoadjuvant pembrolizumab therapy for triple-negative breast cancer: prognostic insights and nomogram construction. J Clin Oncol 2024; 42: e12649-e12649.
  41. Guo Y, Xiang D, Wan J, Yang L, Zheng C. Focus on the dynamics of neutrophil-to-lymphocyte ratio in cancer patients treated with immune checkpoint inhibitors: a meta-analysis and systematic review. Cancers (Basel) 2022; 14: 5297.
  42. Pieniążek M, Polakiewicz-Gilowska A, Las-Jankowska M, Wronowicz J, Jarząb M, Łacko A, et al. Baseline hemoglobin and neutrophil-­to-lymphocyte ratio as prognostic biomarkers in patients with metastatic triple negative breast cancer treated with sacituzumab govitecan in second line and beyond: a real-world analysis. Breast Cancer Res Treat 2025; 214: 397-407.
Copyright: © 2026 Termedia Sp. z o. o. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License (http://creativecommons.org/licenses/by-nc-sa/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
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