Jiaqiang Dan1, Jinya Tan2, Junhua Huang3, Xiaoli Zhang3, Yao Guo3, Yunkun Huang3, Jin Yang3. 1. Department of Breast Surgery, Chengdu Fifth People's Hospital, Chengdu, 611130, Sichuan, People's Republic of China. daniel4234@163.com. 2. Department of Rheumatology and Immunology, Wenjiang District People's Hospital of Chengdu City, Chengdu, 611130, Sichuan, People's Republic of China. 3. Department of Breast Surgery, Chengdu Fifth People's Hospital, Chengdu, 611130, Sichuan, People's Republic of China.
Abstract
BACKGROUND: The pre-treatment neutrophil-lymphocyte ratio (NLR) has been reported to be a predictive factor for pathologic complete response (pCR) after neoadjuvant chemotherapy (NACT) in breast cancer patients. However, whether the dynamic change of post-treatment neutrophil to lymphocyte ratio (delta-NLR) can better predict the same outcome remains unclear. MATERIALS AND METHODS: We retrospectively analyzed 242 consecutive patients affected by breast cancer and candidates of NACT. The complete blood cell counts before and after NACT were evaluated to calculate NLR. The relationships between delta-NLR and pCR, along with other clinical-pathological characteristics were analyzed. Univariate and multivariate analyses were performed using a logistic regression model. RESULTS: Of the 242 patients, 65 (26.9%) achieved a pCR. Pre-treatment NLR and post-treatment NLR were not significantly associated with pCR if analyzed separately in multivariate analyses. However, when combining together, patients with delta-NLR < 0 profile achieved a significantly higher rate of pCR compared to those with delta-NLR ≥ 0 (OR 2.84, 95% CI 1.35-5.96, p = 0.006). Additionally, the predictive value of delta-NLR was independent from common prognostic factors such as Ki-67, and molecular subtypes. CONCLUSIONS: Delta-NLR, rather than pre-treatment or post-treatment NLR is associated with pCR rate, suggesting that the dynamic change of NLR may be an important factor predicting the response to NACT in breast cancer patients.
BACKGROUND: The pre-treatment neutrophil-lymphocyte ratio (NLR) has been reported to be a predictive factor for pathologic complete response (pCR) after neoadjuvant chemotherapy (NACT) in breast cancerpatients. However, whether the dynamic change of post-treatment neutrophil to lymphocyte ratio (delta-NLR) can better predict the same outcome remains unclear. MATERIALS AND METHODS: We retrospectively analyzed 242 consecutive patients affected by breast cancer and candidates of NACT. The complete blood cell counts before and after NACT were evaluated to calculate NLR. The relationships between delta-NLR and pCR, along with other clinical-pathological characteristics were analyzed. Univariate and multivariate analyses were performed using a logistic regression model. RESULTS: Of the 242 patients, 65 (26.9%) achieved a pCR. Pre-treatment NLR and post-treatment NLR were not significantly associated with pCR if analyzed separately in multivariate analyses. However, when combining together, patients with delta-NLR < 0 profile achieved a significantly higher rate of pCR compared to those with delta-NLR ≥ 0 (OR 2.84, 95% CI 1.35-5.96, p = 0.006). Additionally, the predictive value of delta-NLR was independent from common prognostic factors such as Ki-67, and molecular subtypes. CONCLUSIONS: Delta-NLR, rather than pre-treatment or post-treatment NLR is associated with pCR rate, suggesting that the dynamic change of NLR may be an important factor predicting the response to NACT in breast cancerpatients.
Entities:
Keywords:
Breast cancer; Neoadjuvant chemotherapy; Neutrophil–lymphocyte ratio; Pathologic complete response
Authors: Sung Jun Ma; Han Yu; Michael Khan; Jasmin Gill; Sharon Santhosh; Udit Chatterjee; Austin Iovoli; Mark Farrugia; Hemn Mohammadpour; Kimberly Wooten; Vishal Gupta; Ryan McSpadden; Moni A Kuriakose; Michael R Markiewicz; Wesley L Hicks; Mary E Platek; Mukund Seshadri; Andrew D Ray; Elizabeth Repasky; Anurag K Singh Journal: JAMA Netw Open Date: 2022-04-01