Prognostic Significance of Peripheral Blood Parameters as Predictor of Neoadjuvant Chemotherapy Response in Breast Cancer

Ionut Flaviu Faur ^1,2,3, Amadeus Dobrescu ^1,2, Ioana Adelina Clim ⁴

⁰IInd Surgery Clinic, Timisoara Emergency County Hospital, 300723 Timisoara, Romania.

International Journal of Molecular Sciences +

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March 27, 2025

View abstract on PubMed

Summary

Pre-treatment ratios like neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) can predict breast cancer response to neoadjuvant chemotherapy (NACT). Lower NLR, PLR, and SII values correlate with higher pathological complete response (pCR) rates.

Area Of Science

Oncology
Biomarker Research
Breast Cancer Therapeutics

Background

Standard breast cancer treatment involves surgery and systemic therapy.
Predicting response to neoadjuvant chemotherapy (NACT) is crucial for personalized treatment.
Biomarkers are sought to identify patients likely to achieve pathological complete response (pCR).

Purpose Of The Study

To evaluate pre-therapeutic biomarkers for predicting tumor response to NACT in breast cancer.
To assess the association between various analytical parameters and pCR rates.
To identify reliable biomarkers for guiding individualized breast cancer treatment strategies.

Main Methods

Systematic evaluation of patient data including age, TNM stage, and histological/molecular subtypes.
Analysis of biomarker ratios: platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), systemic immune-inflammatory index (SII), and prognostic nutritional index (PNI).
Statistical correlation of pre-therapeutic biomarker values with pCR rates post-NACT.

Main Results

Lower pre-therapeutic NLR, PLR, SII, and LMR values were significantly correlated with higher pCR rates (p < 0.005).
Specific cut-off values for PLR (120.45) and LMR (12.34) showed significant associations with pCR.
NLR between 1 and 3 also demonstrated a significant association with pCR (p = 0.001).

Conclusions

Pre-therapeutic NLR, PLR, SII, and LMR show significant predictive potential for pCR in breast cancer patients undergoing NACT.
These biomarkers can aid in tailoring treatment strategies and improving patient prognosis.
PNI did not demonstrate predictive value for pCR in this study.

Keywords:

neutrophil-to-lymphocyte ratio (NLR) pathological complete response (pCR) platelet-to-lymphocyte ratio (PLR) systemic immune-inflammatory index (SII)