Frontiers in Oncology (May 2023)

A new prognostic model including immune biomarkers, genomic proliferation tumor markers (AURKA and MYBL2) and clinical-pathological features optimizes prognosis in neoadjuvant breast cancer patients

  • Esmeralda García-Torralba,
  • Esmeralda García-Torralba,
  • Esmeralda García-Torralba,
  • Esther Navarro Manzano,
  • Esther Navarro Manzano,
  • Gines Luengo-Gil,
  • Gines Luengo-Gil,
  • Gines Luengo-Gil,
  • Pilar De la Morena Barrio,
  • Pilar De la Morena Barrio,
  • Pilar De la Morena Barrio,
  • Asunción Chaves Benito,
  • Miguel Pérez-Ramos,
  • Beatriz Álvarez-Abril,
  • Beatriz Álvarez-Abril,
  • Beatriz Álvarez-Abril,
  • Alejandra Ivars Rubio,
  • Alejandra Ivars Rubio,
  • Alejandra Ivars Rubio,
  • Elisa García-Garre,
  • Elisa García-Garre,
  • Elisa García-Garre,
  • Francisco Ayala de la Peña,
  • Francisco Ayala de la Peña,
  • Francisco Ayala de la Peña,
  • Elena García-Martínez,
  • Elena García-Martínez,
  • Elena García-Martínez,
  • Elena García-Martínez

DOI
https://doi.org/10.3389/fonc.2023.1182725
Journal volume & issue
Vol. 13

Abstract

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BackgroundUp to 30% of breast cancer (BC) patients treated with neoadjuvant chemotherapy (NCT) will relapse. Our objective was to analyze the predictive capacity of several markers associated with immune response and cell proliferation combined with clinical parameters.MethodsThis was a single-center, retrospective cohort study of BC patients treated with NCT (2001-2010), in whom pretreatment biomarkers were analyzed: neutrophil-to-lymphocyte ratio (NLR) in peripheral blood, CD3+ tumor-infiltrating lymphocytes (TILs), and gene expression of AURKA, MYBL2 and MKI67 using qRT-PCR.ResultsA total of 121 patients were included. Median followup was 12 years. In a univariate analysis, NLR, TILs, AURKA, and MYBL2 showed prognostic value for overall survival. In multivariate analyses, including hormone receptor, HER2 status, and response to NCT, NLR (HR 1.23, 95% CI 1.01-1.75), TILs (HR 0.84, 95% CI 0.73-0.93), AURKA (HR 1.05, 95% CI 1.00-1.11) and MYBL2 (HR 1.19, 95% CI 1.05-1.35) remained as independent predictor variables.ConclusionConsecutive addition of these biomarkers to a regression model progressively increased its discriminatory capacity for survival. Should independent cohort studies validate these findings, management of early BC patients may well be changed.

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