Assessment of the Predictive Role of Serum Lipid Profiles in Breast Cancer Patients Receiving Neoadjuvant Chemotherapy

Abstract

Purpose: Effective predictors of the response to neoadjuvant chemotherapy (NAC) are still insufficient. This study aimed to investigate the predictive value of serum lipid profiles for the response to NAC in breast cancer patients. Methods: A total of 533 breast cancer patients who had received NAC were retrospectively studied. The pretreatment of serum lipids, including total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and lipoprotein-α, and clinicopathological characteristics were collected to assess their predictive roles. Results: Breast cancer patients had significantly lower TC, TG, HDL-C, and LDL-C levels than normal individuals. Among these indicators, TG and LDL-C levels and HDL-C level increased and decreased significantly after NAC, respectively. In estrogen receptor (ER)positive patients, increased LDL-C level was associated with better outcomes. Moreover, the receiver operating characteristic curve analyses suggested that TG and HDL-C levels at diagnosis can be used as predictors of the response to NAC only in the ER-positive subgroup. According to univariate analyses, patients with low TG level (< 1.155 mmol/L) or high HDL-C level (≥ 1.305 mmol/L) in the ER-positive subgroup had more favorable clinical responses than the other patients in the subgroup. Furthermore, according to multivariate analyses, a high HDL-C level (≥ 1.305 mmol/L, p = 0.007) was an independent predictor of NAC efficacy. Conclusion: High HDL-C level (≥ 1.305 mmol/L) before NAC and increased LDL-C level after NAC were associated with the better treatment response in ER-positive breast cancer patients. These results are potentially considered beneficial in establishing treatment decisions.

Construction and Validation of a Serum Albumin-to-Alkaline Phosphatase Ratio-Based Nomogram for Predicting Pathological Complete Response in Breast Cancer

“…In recent years, an accumulating body of research has found that serum parameters can be utilized as predictive factors in breast cancer, such as serum fibrinogen, D-dimer, lipid profiles, lymphocyte to monocyte ratio and platelet to lymphocyte ratio (12,29). ALB and ALP are two accessible routine laboratory indexes.…”

Predictive value of a reduction in the level of high-density lipoprotein-cholesterol in patients with non-small-cell lung cancer undergoing radical resection and adjuvant chemotherapy: a retrospective observational study

“…A lower HDL-C serum level at baseline has also been associated with tumor progression and an increase mortality among various cancers [ 35 – 37 ]. As for the relationship between chemotherapy-related HDL-C and tumors, patients with a high level of HDL-C before chemotherapy were reported to have a better treatment response for breast cancer [ 38 ], gastric cancer [ 35 ], and prostate cancer [ 39 ]. In breast cancer, LDL-C elevation after chemotherapy showed better clinical responses [ 38 ].…”

“…As for the relationship between chemotherapy-related HDL-C and tumors, patients with a high level of HDL-C before chemotherapy were reported to have a better treatment response for breast cancer [ 38 ], gastric cancer [ 35 ], and prostate cancer [ 39 ]. In breast cancer, LDL-C elevation after chemotherapy showed better clinical responses [ 38 ]. Patients with a complete remission exhibited a significant HDL-C elevation after induction treatment for ALL [ 21 ].…”

Effect of postoperative chemotherapy on blood glucose and lipid metabolism in patients with invasive breast cancer

“…In another study, the incidence of dyslipidemia was shown to be low in breast cancer patients, and chemotherapy resulted in a significantly higher incidence of dyslipidemia; the authors thus recommended that lipid metabolism should be tested during chemotherapy (9). Dyslipidemia has been shown to be associated with the efficacy and sensitivity of chemotherapeutic treatment (10). In addition, dyslipidemia can trigger cardiovascular diseases in breast cancer patients (11)(12)(13)(14).…”