Peripheral Blood Cell Ratios as Prognostic Indicators in a Neoadjuvant Chemotherapy-Treated Breast Cancer Cohort

Area of Science:

• Oncology
• Immunology
• Biomarkers

Background:

• Breast cancer is a heterogeneous disease influenced by immune response.
• Systemic blood-based immunocyte ratios are emerging as clinically relevant prognostic biomarkers.
• The prognostic value of various immunocyte ratios in specific breast cancer subtypes following neoadjuvant chemotherapy (NAC) requires further exploration.

Purpose of the Study:

• To evaluate the prognostic value of key immunocyte ratios for overall survival (OS) and disease-free survival (DFS) across different breast cancer subtypes in a NAC cohort.
• To identify specific immunocyte ratios with significant associations with OS and DFS within Luminal A, Luminal B, HER2-positive, and triple-negative breast cancer subtypes.

Main Methods:

• Analysis of a neoadjuvant chemotherapy-treated breast cancer cohort (Luminal A, Luminal B, HER2-positive, triple-negative).
• Calculation of immunocyte ratios (NLR, LMR, NWR, LWR, MWR, PLR) and determination of cut-off values using decision tree modeling (>80% specificity).
• Statistical analysis of the association between immunocyte ratios and subtype-specific OS, DFS, and tumor grade using receiver operating characteristic curves and decision tree modeling.

Main Results:

• Lymphocyte-to-monocyte ratio (LMR) and monocyte-to-white cell count ratio (MWR) were significantly associated with OS and DFS in Luminal A and Luminal B breast cancers.
• Neutrophil-to-lymphocyte ratio (NLR) and lymphocyte-to-white cell count ratio (LWR) showed significant associations with OS in HER2-positive breast cancer.
• NLR and neutrophil-to-white cell count ratio (NWR) were significantly associated with DFS in HER2-positive breast cancer.
• No significant associations were observed for any immunocyte ratio in the triple-negative breast cancer cohort.

Conclusions:

• Immunocyte ratios demonstrate subtype-specific prognostic value in breast cancer patients treated with neoadjuvant chemotherapy.
• Specific ratios like LMR, MWR, NLR, LWR, and NWR can serve as valuable prognostic indicators for different breast cancer subtypes.
• Further validation of these immunocyte ratios may enhance clinical decision-making and patient monitoring in breast cancer management.