Lactate Dehydrogenase-to-Albumin Ratio and Glasgow Prognostic Score as Prognostic Markers in Metastatic Breast Cancer Treated with CDK4/6 Inhibitors.
- 1Division of Medical Oncology, Faculty of Medicine, Celal Bayar University, 45030 Manisa, Turkey.
Abstract
Background: CDK4/6 inhibitors with endocrine therapy are standard first-line treatment for hormone receptor-positive, HER2-negative metastatic breast cancer, yet simple pretreatment prognostic markers are lacking. The LDH-to-albumin ratio (LAR) and the Glasgow Prognostic Score (GPS) both incorporate serum albumin and are each reported as prognostic, but have not been compared within a single cohort, and LAR has not been examined during CDK4/6 inhibitor therapy. This study evaluated both indices in this setting. Methods: Consecutive patients (n = 139) receiving palbociclib or ribociclib plus endocrine therapy (2020-2025) were analysed retrospectively. LAR was modelled continuously on the logarithmic scale, with hazard ratios per doubling; an external cut-off (46.27) served for Kaplan-Meier illustration only. GPS was calculated in its original form. As both contain albumin, each entered a separate multivariable Cox model with identical covariates. Endpoints were overall survival (OS) and progression-free survival (PFS). Results: Over a median follow-up of 50.0 months, 72 deaths and 110 progression events occurred. LAR was independently associated with OS (adjusted HR 2.87 per doubling, 95% CI 1.78-4.62, p < 0.001) and PFS (2.21, 1.45-3.35, p < 0.001). GPS was independently associated with OS (1.72, 1.05-2.82, p = 0.032) but not PFS (1.32, 0.88-1.98, p = 0.187). LAR-based models had lower Akaike information criterion values (ΔAIC 12.3 and 10.9), but concordance did not differ significantly between the indices (ΔC ≈ 0.04, p > 0.20). Conclusions: Baseline LAR, an inexpensive routine index, was associated with both endpoints, whereas GPS was associated with overall survival alone. Discrimination was modest for both indices (C-index ≤ 0.61) and did not differ significantly between them. External validation is required.
Related
- Pretreatment Lactate Dehydrogenase-to-Albumin Ratio Identifies an Early Adverse Prognostic Profile in IDH-Wildtype Glioblastoma: A Real-World Cohort Study.
- The lactate dehydrogenase-to-albumin ratio is independently associated with moderate-to-severe tubulointerstitial fibrosis in patients with IgA nephropathy.
- The lactate dehydrogenase-to-albumin ratio predicts frequent exacerbations in COPD patients with coronary heart disease
- Lactate dehydrogenase to albumin ratio as a potential indicator of pathological response and prognosis in non-small cell lung cancer patients undergoing neoadjuvant chemoimmunotherapy followed by surgery.
- A nutrition–inflammation index weighted toward disease burden: the lactate dehydrogenase-to-albumin ratio in TP53-mutated myeloid neoplasms
BibTeX
@article{hafizoglu2026lactate,
title = {{Lactate Dehydrogenase-to-Albumin Ratio and Glasgow Prognostic Score as Prognostic Markers in Metastatic Breast Cancer Treated with CDK4/6 Inhibitors.}},
author = {Ece Sahin Hafizoglu and Ferhat Ekinci and Mustafa Sahbazlar and Atike Pinar Erdogan},
journal = {Current oncology (Toronto, Ont.)},
year = {2026},
month = sep,
doi = {10.3390/curroncol33100582},
url = {https://europepmc.org/article/MED/42930149},
note = {CC BY},
}
RIS
TY - JOUR
TI - Lactate Dehydrogenase-to-Albumin Ratio and Glasgow Prognostic Score as Prognostic Markers in Metastatic Breast Cancer Treated with CDK4/6 Inhibitors.
AU - Ece Sahin Hafizoglu
AU - Ferhat Ekinci
AU - Mustafa Sahbazlar
AU - Atike Pinar Erdogan
PY - 2026
DA - 2026/09/29
JO - Current oncology (Toronto, Ont.)
DO - 10.3390/curroncol33100582
UR - https://europepmc.org/article/MED/42930149
AB - Background: CDK4/6 inhibitors with endocrine therapy are standard first-line treatment for hormone receptor-positive, HER2-negative metastatic breast cancer, yet simple pretreatment prognostic markers are lacking. The LDH-to-albumin ratio (LAR) and the Glasgow Prognostic Score (GPS) both incorporate serum albumin and are each reported as prognostic, but have not been compared within a single cohort, and LAR has not been examined during CDK4/6 inhibitor therapy. This study evaluated both indices in this setting. Methods: Consecutive patients (n = 139) receiving palbociclib or ribociclib plus endocrine therapy (2020-2025) were analysed retrospectively. LAR was modelled continuously on the logarithmic scale, with hazard ratios per doubling; an external cut-off (46.27) served for Kaplan-Meier illustration only. GPS was calculated in its original form. As both contain albumin, each entered a separate multivariable Cox model with identical covariates. Endpoints were overall survival (OS) and progression-free survival (PFS). Results: Over a median follow-up of 50.0 months, 72 deaths and 110 progression events occurred. LAR was independently associated with OS (adjusted HR 2.87 per doubling, 95% CI 1.78-4.62, p < 0.001) and PFS (2.21, 1.45-3.35, p < 0.001). GPS was independently associated with OS (1.72, 1.05-2.82, p = 0.032) but not PFS (1.32, 0.88-1.98, p = 0.187). LAR-based models had lower Akaike information criterion values (ΔAIC 12.3 and 10.9), but concordance did not differ significantly between the indices (ΔC ≈ 0.04, p > 0.20). Conclusions: Baseline LAR, an inexpensive routine index, was associated with both endpoints, whereas GPS was associated with overall survival alone. Discrimination was modest for both indices (C-index ≤ 0.61) and did not differ significantly between them. External validation is required.
SN - 1198-0052
SN - 1718-7729
ER -