Prognostic significance of the neutrophil to lymphocyte ratio in locally advanced breast cancer

Bader Alshamsan ^1,2, Mahmoud A Elshenawy ^2,3, Mohamed Aseafan ^2,4

⁰Department of Medicine, College of Medicine, Qassim University, Buraydah, Qassim 52571, Kingdom of Saudi Arabia.

Oncology Letters +

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July 25, 2024

View abstract on PubMed

Summary

A low pre-treatment neutrophil-to-lymphocyte ratio (NLR) predicts a better response to neoadjuvant chemotherapy (NAC) in locally advanced breast cancer (LABC). This prognostic factor is particularly significant for triple-negative breast cancer (TNBC) survival outcomes.

Area Of Science

Oncology
Medical Research
Biomarkers

Background

Locally advanced breast cancer (LABC) requires effective neoadjuvant chemotherapy (NAC).
Predicting treatment response and survival outcomes in LABC patients is crucial.
Conflicting data exists regarding the prognostic role of pre-treatment neutrophil-to-lymphocyte ratio (NLR).

Purpose Of The Study

To clarify the prognostic value of pre-treatment NLR for NAC response in LABC.
To evaluate the association between NLR and pathological complete response (pCR) rates.
To assess the impact of NLR on disease-free survival (DFS) and overall survival (OS).

Main Methods

Retrospective analysis of 465 LABC patients treated with NAC (2005-2014).
Stratification into low (≤2.2) and high (>2.2) NLR groups based on ROC curve analysis.
Logistic and Cox regression analyses to determine associations with pCR and survival.

Main Results

Low NLR group showed significantly higher pCR rates (OR, 2.59; P<0.001).
Low NLR group had improved 5-year DFS (75.8% vs. 64.9%; HR, 0.69; P=0.02) and OS (90.3% vs. 81.9%; HR, 0.62; P=0.04).
Subgroup analysis indicated that triple-negative breast cancer (TNBC) patients drove the survival outcome significance.

Conclusions

Pre-treatment NLR is a viable independent prognostic factor for pCR in LABC patients receiving NAC.
NLR impacts survival outcomes, with low NLR associated with better DFS and OS.
The prognostic role of NLR is particularly pronounced in the TNBC subgroup.

Keywords:

BC NAC NLR pCR residual disease triple-negative