Abstract
We aimed to investigate the correlation between neutrophil-to-lymphocyte ratio (NLR) and pathologic complete response (pCR) and survival outcomes in human epidermal growth factor receptor 2 (HER2)-negative breast cancer patients who received neoadjuvant chemotherapy. The baseline NLR was evaluated in non-metastatic, HER2-negative breast cancer patients who received neoadjuvant chemotherapy. Baseline NLR was calculated as absolute neutrophil per lymphocyte count from pre-treatment blood samples. Any value ≥ 2.74 was considered to be a high NLR. In the 1,097 patients studied, 272 (24.4%) had high NLR and 825 (75.6%) had low NLR. The high NLR was an independent factor for pCR (OR 0.595; 95% CIs 0.398–0.890; P = 0.011). Furthermore, high NLR was a significant independent parameter affecting DFS (HR 2.298; 95% CIs 1.691–3.124; P < 0.001) and OS (HR 1.905; 95% CIs 1.167–3.108; P = 0.010). Regardless of the baseline NLR, survival outcomes were excellent in patients who achieved pCR, but high NLR was associated with worse survival for patients with residual invasive disease. Our study showed that NLR was predictive for treatment response and a prognostic factor in patients with HER2-negative breast cancer who received neoadjuvant chemotherapy. Moreover, we identified that high NLR was associated with poor survival outcomes in patients who did not achieve pCR.
Highlights
We aimed to investigate the correlation between neutrophil-to-lymphocyte ratio (NLR) and pathologic complete response and survival outcomes in human epidermal growth factor receptor 2 (HER2)-negative breast cancer patients who received neoadjuvant chemotherapy
High tumor-infiltrating lymphocytes (TILs) has been identified as biomarker related to pathologic complete response (pCR) and better clinical outcomes in patients with breast cancer who received neoadjuvant c hemotherapy[25]
Similar to TILs, we found that the NLR was an independent factor for pCR and survival in patients with HER2-negative breast cancer who received neoadjuvant chemotherapy
Summary
We aimed to investigate the correlation between neutrophil-to-lymphocyte ratio (NLR) and pathologic complete response (pCR) and survival outcomes in human epidermal growth factor receptor 2 (HER2)-negative breast cancer patients who received neoadjuvant chemotherapy. Our study showed that NLR was predictive for treatment response and a prognostic factor in patients with HER2-negative breast cancer who received neoadjuvant chemotherapy. Neoadjuvant chemotherapy has survival outcomes equivalent to those of adjuvant chemotherapy[2,3], and has the following advantages: it can increase the rate of breast-conserving surgery by reducing the size and extent of locally advanced tumors, control occult micro-metastasis, and estimate sensitivity to treatment regimen[4,5]. The current study aimed to investigate the relationship between pre-treatment NLR and clinical outcomes in HER2-negative breast cancer patients who received neoadjuvant chemotherapy. We explored whether NLR had a bearing on the survival outcomes of patients who attained pCR and those who did not
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