Use of PLR and NLR to evaluate the efficacy and prognosis of neoadjuvant chemotherapy with lobaplatin in triple-negative breast cancer.

Abstract

594 Background: Previously, we showed that addition of lobaplatin (L) to taxane (T) combined with anthracycline (E) could improve the pathological complete response (pCR) rate of neoadjuvant therapy for triple-negative breast cancer (TNBC) and lengthen long-term survival significantly, but the therapeutic markers of this regimen are not known. We investigated if the platelet/lymphocyte ratio (PLR) and neutrophil/lymphocyte ratio (NLR) could be used to predict the efficacy of the TEL regimen. Methods: Eighty-three patients with TNBC (stage I–III) who received TEL (docetaxel (T) at 75 mg/m2, epirubicin (E) at 80 mg/m2, and lobaplatin (L) at 30 mg/m2) from January 2014 to August 2019 were recruited. They received four cycles before surgery and two cycles after surgery. Patients were divided into four groups according to the mean values of the PLR (145.71) and NLR (2.74): high PLR (PLR+), low PLR (PLR−), high NLR (NLR+), and low NLR (NLR−). Differences in the total pathologic complete response (tpCR) rate, event-free survival (EFS), and overall survival (OS) were analyzed in different groups of patients using the TEL protocol. Results: The tpCR rate in the PLR− group was 49.0% (25/51), which was significantly higher than that in the PLR+ group (25.0% (8/32); odds ratio (OR) = 2.885, 95% confidence interval (CI) = 1.093–7.612, P = 0.032). The tpCR rate in the NLR− group was 49.1% (26/53), which was significantly higher than that in the NLR+ group (23.3% (7/30); OR = 3.164, 95% CI = 1.161–8.626, P = 0.024). The tpCR rate of the PLR−NLR− group was 53.7% (22/41), which was significantly higher than that of the PLR+/NLR+ group (26.1% (11/42), with a high proportion of any index (OR = 3.263, 95% CI = 1.298–8.204, P = 0.012). The median duration of follow-up was 69 months. EFS and OS in the NLR− group were significantly longer than those in the NLR+ group (hazard ratio (HR) = 5.946, 95% CI = 1.526–23.169, P = 0.010 for EFS; HR = 7.803, 95% CI = 1.565–38.907, P = 0.012 for OS). Five-year EFS was 95.1% for the PLR−NLR− group, 91.0% for the PLR+NLR− group, 76.0 for the PLR+NLR+ group, and 59.1% for the PLR−NLR+ group. Compared with the PLR+/NLR+ group, patients in the PLR-NLR- group had the longest EFS (P = 0.002). Conclusions: PLR and NLR could be used to predict the efficacy of neoadjuvant therapy with taxane, anthracycline, and lobaplatin regimen in TNBC, and the low-proportion group had a higher tpCR rate and a better long-term prognosis. Clinical trial information: ChiCTR-TRC-14005019 .