Introduction
Breast cancer (BC) remains a significant global health issue, posing a severe threat to women’s health worldwide. Despite advancements in treatment, the overall survival (OS) rates for BC patients are still not optimal. This has led to a growing interest in identifying reliable prognostic markers that can predict survival outcomes and guide treatment strategies. One such emerging marker is the hemoglobin, albumin, lymphocyte, and platelet (HALP) score, which has shown promise in various cancers.
Objective
This systematic review and meta-analysis aim to evaluate the prognostic value of the HALP score in breast cancer patients. Specifically, the study investigates the association between HALP scores and overall survival (OS) and disease-free survival (DFS) in BC patients.
Methods
The study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search was conducted across databases such as PubMed, EMBASE, Web of Science, Cochrane Library, and Google Scholar for studies published up to July 3, 2025. The quality of the studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) and the Newcastle-Ottawa Scale (NOS). Statistical analyses were performed using MetaDiSc 1.4, Stata SE 18, and Review Manager 5.4.
Results
Out of 971 studies initially identified, nine met the inclusion criteria, encompassing a total of 4,560 patients. The meta-analysis revealed that a higher HALP score was significantly associated with improved OS (HR = 0.61, 95% CI 0.39-0.97, p < 0.05). However, no significant association was found between HALP scores and DFS in BC patients. The area under the summary receiver operating characteristics (SROC) curve for predicting pathological complete response (pCR) was 0.57.
Discussion
The HALP score, initially proposed for gastric cancer prognosis, has emerged as a cost-effective prognostic marker in breast cancer. It reflects the patient’s systemic inflammatory status and immune nutritional status, providing a practical reference for predicting clinical outcomes. Despite its promise, the HALP score’s predictive value for DFS and pCR in BC remains limited.
Conclusion
The HALP score shows potential as a prognostic biomarker for overall survival in breast cancer patients. However, its utility in predicting disease-free survival and pathological complete response is less clear. Future research should focus on large-scale, prospective studies to validate these findings and explore the HALP score’s applicability across different BC subtypes.
Limitations
The study’s limitations include a relatively small sample size and the retrospective design of the included studies, which may introduce selection and information biases. Additionally, the studies primarily focused on Asian populations, limiting the generalizability of the findings.
Future Directions
Prospective multicenter studies are needed to confirm the HALP score’s prognostic value in breast cancer. Standardizing the cutoff values for the HALP score and integrating it with other biomarkers could enhance its predictive accuracy and clinical utility.
🔗 **Fuente:** https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2025.1684940/full