Author:
Şahin Ahmet Bilgehan,Cubukcu Erdem,Ocak Birol,Deligonul Adem,Oyucu Orhan Sibel,Tolunay Sahsine,Gokgoz Mustafa Sehsuvar,Cetintas Sibel,Yarbas Gorkem,Senol Kazım,Goktug Mehmet Refik,Yanasma Zeki Burak,Hasanzade Ulviyya,Evrensel Turkkan
Abstract
AbstractBlood-based biomarkers reflect systemic inflammation status and have prognostic and predictive value in solid malignancies. As a recently defined biomarker, Pan-Immune-Inflammation-Value (PIV) integrates different peripheral blood cell subpopulations. This retrospective study of collected data aimed to assess whether PIV may predict the pathological complete response (pCR) to neoadjuvant chemotherapy (NAC) in Turkish women with breast cancer. The study consisted of 743 patients with breast cancer who were scheduled to undergo NAC before attempting cytoreductive surgery. A pre-treatment complete blood count was obtained in the two weeks preceding NAC, and blood-based biomarkers were calculated from absolute counts of relevant cell populations. The pCR was defined as the absence of tumor cells in both the mastectomy specimen and lymph nodes. Secondary outcome measures included disease-free survival (DFS) and overall survival (OS). One hundred seven patients (14.4%) had pCR. In receiver operating characteristic analysis, optimal cut-off values for the neutrophile-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte (PLR), PIV, and Ki-67 index were determined as ≥ 2.34, ≥ 0.22, ≥ 131.8, ≥ 306.4, and ≥ 27, respectively. The clinical tumor (T) stage, NLR, MLR, PLR, PIV, estrogen receptor (ER) status, human epidermal growth factor receptor-2 (HER-2) status, and Ki-67 index were significantly associated with NAC response in univariate analyses. However, multivariate analysis revealed that the clinical T stage, PIV, ER status, HER-2 status, and Ki-67 index were independent predictors for pCR. Moreover, the low PIV group patients had significantly better DFS and OS than those in the high PIV group (p = 0.034, p = 0.028, respectively). Based on our results, pre-treatment PIV seems as a predictor for pCR and survival, outperforming NLR, MLR, PLR in predicting pCR in Turkish women with breast cancer who received NAC. However, further studies are needed to confirm our findings.
Publisher
Springer Science and Business Media LLC
Reference42 articles.
1. Winters, S., Martin, C., Murphy, D. & Shokar, N. K. Breast cancer epidemiology, prevention, and screening. Prog. Mol. Biol. Transl. Sci. 151, 1–32 (2017).
2. Rojas, K. & Stuckey, A. Breast cancer epidemiology and risk factors. Clin. Obstet. Gynecol. 59, 651–672 (2016).
3. Doval, D. C., Dutta, K., Batra, U. & Talwar, V. Neoadjuvant chemotherapy in breast cancer: Review of literature. J. Indian Med. Assoc. 111, 629–631 (2013).
4. Mathew, J. et al. Neoadjuvant chemotherapy for locally advanced breast cancer: A review of the literature and future directions. Eur. J. Surg. Oncol. 35, 113–122 (2009).
5. National Comprehensive Cancer Network. Breast Cancer. Version 5.2021. Available at: https://www.nccn.org/professionals/physician_gls/pdf/breast.pdf.