Abstract P1-08-11: Clinical relevance of host immunity in patients with breast cancer who received neoadjuvant chemotherapy

Abstract

Abstract Background Host immunity plays a key role in breast cancer progression. It seems that the neutrophil-to-lymphocyte ratio (NLR) may reflect the systemic host immunity, and tumor-infiltrating lymphocytes (TILs) may reflect the localized host immunity. This study aimed to analyze the clinical relevance of host immunity combining NLR and TILs to treatment efficacy and survival.Methods We assessed the pre-treatment NLR and TILs from core-biopsy samples in 461 patients with breast cancer who received neoadjuvant chemotherapy. The patients were assigned into two groups: the intact host immunity group (NLR < 2.75 and TILs ≥ 30%) and the defective host immunity group (the remainder; NLR > 2.75 or TILs < 30%). We investigated the pathologic complete response (pCR) and recurrence-free survival (RFS) according to host immunity.ResultsOf the total, 141 (30.6%) patients belong to the intact host immunity group, and 320 (69.4%) patients belong to the defective host immunity group. A pCR was achieved in 76 (53.9%) of 141 patients in the intact host immunity group, whereas a pCR was achieved in 96 (30.0%) of 320 patients in the defective host immunity group (P<0.001). The intact host immunity was an independent predictor for high pCR (adjusted odds ratio [OR], 2.65; 95% confidence interval [CI], 1.74-4.03). Furthermore, the Cox proportional hazards regression models revealed that the intact host immunity obtained an independent prognostic value for favorable RFS after adjusted for clinicopathologic factors including pCR (adjusted hazard ratio [HR], 0.33; 95% CI, 0.11-0.98; P=0.045).ConclusionHost immunity based on the combined analysis of NLR and TILs provides information regarding the treatment response and prognosis in patients with breast cancer receiving neoadjuvant chemotherapy. There is a need for a new therapeutic strategy to activate the immune system in patients with defective host immunity. 2 Citation Format: Soong June Bae, Jung Hwan Ji, Chihhao Chu, Yoon Jin Cha, Jee Hung Kim, Sung Gwe Ahn, Joon Jeong. Clinical relevance of host immunity in patients with breast cancer who received neoadjuvant chemotherapy [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P1-08-11.