Tumor Necrosis Factor-alpha Levels as a Predictor of Clinical Neoadjuvant Chemotherapy Response in a Luminal-type Locally Advance Breast Cancer in Surabaya, Indonesia

Abstract

ABSTRACT Introduction: The prevalence of locally advanced breast cancer (LABC) increases annually, especially in the luminal type. Chemotherapy is one of the treatments used to manage breast cancer. Biomarkers are needed to predict the outcome of chemotherapy, one of which is tumor necrosis factor-alpha (TNF-α). The purpose of this study was to analyze TNF-α levels as a predictor factor for clinical response to anthracycline-based neoadjuvant chemotherapy. Methods: This study design used observational analysis. The study was carried out over the period from April 2021 to June 2023. The study procedure included measuring participants’ TNF-α levels the day before chemotherapy was carried out and their clinical response. Participants received anthracycline-based neoadjuvant chemotherapy (cyclophosphamide 500 mg/m2, doxorubicin 50 mg/m2, and fluorouracil/5 FU 500 mg/m2) for 3 cycles. The study analysis used the Chi-square with P < 0.05. Results: The average TNF-α levels were 119.76 ± 282.18 pg/mL, ranging from 5.74 to 1.733 pg/mL. The result of the calculation of the TNF-α cutoff value in the study was 20.980 pg/mL (area under the curve = 0.882; 95% confidence interval = 0.779–0.984). Based on the cutoff, most participants with high TNF-α levels had a negative response of 83.3%, and those with low TNF-α levels had a positive response of 84.2% (P = 0.000). The statistical analysis showed a significant association between TNF-α levels and the clinical response to chemotherapy. Conclusions: TNF-α levels predict clinical response for anthracycline-based neoadjuvant chemotherapy in luminal-type LABC patients.