The role of laboratory indices on treatment response and survival in breast cancer receiving neoadjuvant chemotherapy

Area of Science:

• Oncology
• Medical Diagnostics
• Biomarkers

Background:

• Neoadjuvant chemotherapy (NACT) is standard for locally advanced, high-risk breast cancer.
• Pathological complete response (pCR) after NACT is linked to improved survival.
• Peripheral blood indices reflecting inflammation and nutrition are explored as prognostic markers in malignancies.

Purpose of the Study:

• To investigate the predictive and prognostic value of eight common peripheral blood-derived indices in patients receiving NACT for locally advanced breast cancer.
• To assess the association of these indices with pCR and patient survival outcomes (overall survival [OS], progression-free survival [PFS], and disease-free survival [DFS]).

Main Methods:

• Retrospective analysis of 624 locally advanced breast cancer patients treated with NACT.
• Calculation of eight peripheral blood indices from samples taken two weeks pre-chemotherapy.
• Determination of optimal cut-off values using Receiver Operating Characteristic (ROC) curve analysis.
• Statistical analysis including univariate and multivariate models to assess associations with pCR and survival.

Main Results:

• pCR was achieved in 26.6% of patients.
• Univariate analysis showed significant associations for NLR, PLR, SII, PNI, HALP, and HRR with pCR or survival.
• Multivariate analysis identified Neutrophil-to-Lymphocyte Ratio (NLR) as a significant predictor of pCR (p=0.04).
• The Hemoglobin/Red Cell Distribution Width (HGB/RDW) score significantly predicted DFS (p=0.04).
• Platelet-to-Lymphocyte Ratio (PNI) score was a significant predictor for both OS and PFS (p=0.01 for both).

Conclusions:

• Peripheral blood-derived indices demonstrate prognostic and predictive value for pCR and survival in breast cancer patients undergoing NACT.
• NLR, HGB/RDW, and PNI emerged as key indicators.
• Further research is warranted to validate these findings and their clinical utility.