Alexandra von Au1,2, Samra Shencoru3, Lorenz Uhlmann4, Luisa Mayer3, Laura Michel5, Markus Wallwiener3, André Hennigs3, Thomas Deutsch3, Fabian Riedel3, Joerg Heil3, Michael Golatta3, Andreas Schneeweiss5, Florian Schütz3, Christoph Domschke3. 1. Department of Gynecology and Obstetrics, Heidelberg University Women's Hospital, INF 440, 69120, Heidelberg, Germany. alexandra.vonau@med.uni-heidelberg.de. 2. National Center for Tumor Diseases (NCT), Heidelberg University Hospital, INF 460, 69120, Heidelberg, Germany. alexandra.vonau@med.uni-heidelberg.de. 3. Department of Gynecology and Obstetrics, Heidelberg University Women's Hospital, INF 440, 69120, Heidelberg, Germany. 4. Institute of Medical Biometry and Informatics, University of Heidelberg, INF 130.3, 69120, Heidelberg, Germany. 5. National Center for Tumor Diseases (NCT), Heidelberg University Hospital, INF 460, 69120, Heidelberg, Germany.
Abstract
PURPOSE: Breast cancer (BC) is the most common malignancy among women and prognosis is strongly influenced by tumor subtype. Neoadjuvant chemotherapy (NAC) is the standard treatment for both locally advanced- and early-stage triple-negative and Her2-positive BC. Pathologic complete response (pCR) to NAC is an important predictor of patient outcomes. Neutrophil-to-lymphocyte-ratio (NLR) in peripheral blood is associated with prognosis in various malignancies. Here, we investigated the value of the pretreatment NLR as a response predictor in neoadjuvant-treated patients with BC. METHODS: A retrospective chart analysis of 862 patients with invasive BC treated with NAC at the Heidelberg University Hospital during 2003-2015 was conducted. NLR was calculated as the ratio of the absolute neutrophil and lymphocyte counts in peripheral blood, and pCR was defined as absence of invasive or in situ carcinoma in breast and axillary lymph nodes. RESULTS: A total of 151 patients with invasive BC who underwent NAC were included in this study. NLR tended to be higher in the pCR group than the non-pCR group (p < 0.1). Analyses of BC subtypes demonstrated that NLR was significantly higher in the pCR- compared with the non-pCR group (3.304 vs. 2.379, respectively; p = 0.048) in patients with luminal B/Her2-negative tumors. Further, we found a significant difference in NLR according to remission status in postmenopausal patients (2.861 vs. 2.313, respectively; p = 0.043). CONCLUSION: NLR was significantly higher only for patients achieving pCR in the Luminal B/Her2-negative and postmenopausal subgroups. Hence, NLR is a candidate additional predictive factor in patients with Luminal B/Her2-negative BC.
PURPOSE: Breast cancer (BC) is the most common malignancy among women and prognosis is strongly influenced by tumor subtype. Neoadjuvant chemotherapy (NAC) is the standard treatment for both locally advanced- and early-stage triple-negative and Her2-positive BC. Pathologic complete response (pCR) to NAC is an important predictor of patient outcomes. Neutrophil-to-lymphocyte-ratio (NLR) in peripheral blood is associated with prognosis in various malignancies. Here, we investigated the value of the pretreatment NLR as a response predictor in neoadjuvant-treated patients with BC. METHODS: A retrospective chart analysis of 862 patients with invasive BC treated with NAC at the Heidelberg University Hospital during 2003-2015 was conducted. NLR was calculated as the ratio of the absolute neutrophil and lymphocyte counts in peripheral blood, and pCR was defined as absence of invasive or in situ carcinoma in breast and axillary lymph nodes. RESULTS: A total of 151 patients with invasive BC who underwent NAC were included in this study. NLR tended to be higher in the pCR group than the non-pCR group (p < 0.1). Analyses of BC subtypes demonstrated that NLR was significantly higher in the pCR- compared with the non-pCR group (3.304 vs. 2.379, respectively; p = 0.048) in patients with luminal B/Her2-negative tumors. Further, we found a significant difference in NLR according to remission status in postmenopausal patients (2.861 vs. 2.313, respectively; p = 0.043). CONCLUSION: NLR was significantly higher only for patients achieving pCR in the Luminal B/Her2-negative and postmenopausal subgroups. Hence, NLR is a candidate additional predictive factor in patients with Luminal B/Her2-negative BC.
Authors: Dilan A Patel; Jing Xi; Jingqin Luo; Bilal Hassan; Shana Thomas; Cynthia X Ma; Jian L Campian Journal: Breast Cancer Res Treat Date: 2019-01-02 Impact factor: 4.872
Authors: Graeme J K Guthrie; Kellie A Charles; Campbell S D Roxburgh; Paul G Horgan; Donald C McMillan; Stephen J Clarke Journal: Crit Rev Oncol Hematol Date: 2013-04-17 Impact factor: 6.312
Authors: Christoph Suppan; Vesna Bjelic-Radisic; Marlen La Garde; Andrea Groselj-Strele; Katharina Eberhard; Hellmut Samonigg; Hans Loibner; Nadia Dandachi; Marija Balic Journal: BMC Cancer Date: 2015-12-29 Impact factor: 4.430