Therapeutic Advances in Medical Oncology (Aug 2023)

Low neutrophil-to-lymphocyte ratio and pan-immune-inflammation-value predict nodal pathologic complete response in 1274 breast cancer patients treated with neoadjuvant chemotherapy: a multicenter analysis

  • Maria Luisa Gasparri,
  • Sara Albasini,
  • Marta Truffi,
  • Karin Favilla,
  • Barbara Tagliaferri,
  • Francesca Piccotti,
  • Daniela Bossi,
  • Giulia Armatura,
  • Arianna Calcinotto,
  • Corrado Chiappa,
  • Francesca Combi,
  • Annalisa Curcio,
  • Angelica Della Valle,
  • Guglielmo Ferrari,
  • Secondo Folli,
  • Matteo Ghilli,
  • Chiara Listorti,
  • Stefano Mancini,
  • Peter Marinello,
  • Simone Mele,
  • Anna Pertusati,
  • Manuela Roncella,
  • Lorenzo Rossi,
  • Francesca Rovera,
  • Silvia Segattini,
  • Adele Sgarella,
  • Daniela Tognali,
  • Fabio Corsi

DOI
https://doi.org/10.1177/17588359231193732
Journal volume & issue
Vol. 15

Abstract

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Background: Systemic inflammatory markers draw great interest as potential blood-based prognostic factors in several oncological settings. Objectives: The aim of this study is to evaluate whether neutrophil-to-lymphocyte ratio (NLR) and pan-immune-inflammation value (PIV) predict nodal pathologic complete response (pCR) after neoadjuvant chemotherapy (NAC) in node-positive (cN+) breast cancer (BC) patients. Design: Clinically, cN+ BC patients undergoing NAC followed by breast and axillary surgery were enrolled in a multicentric study from 11 Breast Units. Methods: Pretreatment blood counts were collected for the analysis and used to calculate NLR and PIV. Logistic regression analyses were performed to evaluate independent predictors of nodal pCR. Results: A total of 1274 cN+ BC patients were included. Nodal pCR was achieved in 586 (46%) patients. At multivariate analysis, low NLR [odds ratio (OR) = 0.71; 95% CI, 0.51–0.98; p = 0.04] and low PIV (OR = 0.63; 95% CI, 0.44–0.90; p = 0.01) were independently predictive of increased likelihood of nodal pCR. A sub-analysis on cN1 patients ( n = 1075) confirmed the statistical significance of these variables. PIV was significantly associated with axillary pCR in estrogen receptor (ER)−/human epidermal growth factor receptor 2 (HER2)+ (OR = 0.31; 95% CI, 0.12–0.83; p = 0.02) and ER−/HER2− (OR = 0.41; 95% CI, 0.17–0.97; p = 0.04) BC patients. Conclusion: This study found that low NLR and PIV levels predict axillary pCR in patients with BC undergoing NAC. Registration: Eudract number NCT05798806.