Increased derived neutrophil-to-lymphocyte ratio and Breast Imaging-Reporting and Data System classification predict poor survival in patients with non-distant metastatic HER2+ breast cancer treated with neoadjuvant chemotherapy

Li, Yuyong; Shao, Yi; Bai, Lishan; Zhou, Xingwei

doi:10.2147/cmar.s174537

Cited by 12 publications

(12 citation statements)

References 48 publications

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“…Furthermore, only 81 of 155 patients received targeted therapy in this study, with the outcome of worse survival. Findings from a study investigating the prognostic significance of derived NLR in 310 patients who had HER2+ breast cancer and underwent neoadjuvant chemotherapy, amassing a median follow-up time of 62.5 months (9.6–138.5 months) established 270 cases of recurrent or metastatic disease, 246 dead cases, and 16 lost follow-up cases 50. These cases had poor prognoses comparative to those in our study.…”

Section: Discussioncontrasting

confidence: 45%

<p>Increased systemic immune-inflammation index independently predicts poor survival for hormone receptor-negative, HER2-positive breast cancer patients</p>

Sun¹,

Li²,

Li³

et al. 2019

CMAR

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Purpose: We sought to examine the role of pretreatment systemic immune-inflammation index (SII) in hormone receptor-negative, human epidermal growth factor receptor 2+ (HER2+) breast cancer patients. Patients and methods: 155 HER2+ patients treated in our hospital from September 3, 2002, to September 21, 2012, were retrospectively enrolled. SII was established as neutrophil x platelet/lymphocyte counts. The median value of SII was used as cut-off value. We used the Kaplan-Meier method to evaluate the overall survival (OS), disease-free survival (DFS), distant metastasis-free survival (DMFS). To comparatively evaluate the survival rates between patients from two groups, we used the log-rank test. For identifying independent factors of prognosis, we used the Cox regression model, applying multivariate statistics. Results: Analyses show that HER2+ patients with high and low SII had median DFS of 15.1 and 31.5 months, respectively ( P <0.001), while the median DMFS in HER2+ patients with high SII was 18.4 and in patients with low SII was 33.0 months ( P =0.001), and the median OS were 54.5 and 71.1 months respectively in high and low SII patients, respectively ( P =0.002). Multivariate analysis had revealed increased SII independently linked to poor DFS (HR =1.46, 95% CI: 1.01–2.11, P =0.045). The difference between SII and DMFS bore no statistical significance. (HR =1.40, 95% CI: 0.96–2.03, P =0.078), while high SII independently predicted short OS (HR =1.51, 95% CI: 1.02–2.25, P =0.038). Conclusion: Our findings suggest that increased SII independently predicts poor survival for hormone receptor-negative, HER2+ breast cancer patients. Prospective studies are, however, required to confirm the role of SII in the prognosis of patients with HER2+ before clinical use.

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Section: Discussioncontrasting

confidence: 45%

<p>Increased systemic immune-inflammation index independently predicts poor survival for hormone receptor-negative, HER2-positive breast cancer patients</p>

Sun¹,

Li²,

Li³

et al. 2019

CMAR

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“…Neutrophil-to-lymphocyte ratio (NLR) predicts disease progression and overall survival (OS) in NSCLC patients (22)(23)(24). Derived NLR (dNLR) was used as an alternative to NLR in studies in which lymphocyte count was not available (25) and was shown to predict poor prognosis in both hematologic and solid tumors (26)(27)(28)(29). Although NLR and dNLR were shown to have prognostic value in patients with advanced NSCLC who were receiving ICI (22,23), the biomarkers measured at baseline do not reflect changes in inflammatory status after initiation of chemotherapy.…”

Section: Introductionmentioning

confidence: 99%

Predictability of early changes in derived neutrophil-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio in patients with advanced non-small cell lung cancer treated with immune checkpoint inhibitors

Lim¹,

Kang²,

Yeo³

et al. 2021

J Thorac Dis

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Background: As association between systemic inflammation and disease progression has been suggested, early changes in neutrophil-to-lymphocyte ratio (NLR) and derived NLR (dNLR) may have accurate predictability for prognosis in non-small cell lung cancer (NSCLC) treated with ICI therapy. Methods: Complete blood count (CBC) was measured immediately before the first and second cycles of ICI therapy in patients with advanced NSCLC. Differences in NLR and dNLR were measured. When the increase in NLR was ≥1, the patient was classified into the increased NLR group. Similarly, when the increase in dNLR was ≥1, the patient was classified into the increased dNLR group; otherwise, they were classified into the non-increased NLR or dNLR group.Results: A total of 89 patients was selected for evaluation. Median progression-free survival (PFS) was significantly shorter in the increased NLR group than in the non-increased NLR group (2.6 vs. 9.5 months, P<0.001). The increased dNLR group showed significantly shorter median PFS than the non-increased dNLR group (4.2 vs. 9.2 months, P=0.001). Association with PFS was analyzed using the Cox regression model. In model 1, increase ≥1 in NLR showed significant association (HR =3.085, 95% CI, 1.657-5.742, P<0.001). In model 2, increase ≥1 in dNLR showed significant association (HR =2.826, 95% CI, 1.436-5.561, P=0.003). Conclusions: Early changes in dNLR were shown to have prognostic value in patients undergoing immunotherapy. It can be an accurate and a comprehensive biomarker for predicting ICI response.

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“…Widmann et al first reported the correlation between the NLR and BC prognosis in 316 patients, and it was found that a higher NLR (≥3.3) before treatment was an adverse factor for both short-and long-term mortality (15). The majority of retrospective studies thereafter have drawn similar conclusions (16)(17)(18)(19), and the NLR was found to be consistent among different BC subtypes at baseline (20,21). However, a prospective substudy of GEICAM/9906, which comprised 1,246 patients, did not find any prognostic value of the NLR after adjustment for clinicopathological factors; in addition, a high NLR was independently associated with worse DFS in only highrisk patients (the hormone receptor-negative/HER2+ population and in patients with ≥3 lymph node metastases) (22).…”

Section: Prognostic Value Of the Neutrophil-to-lymphocyte Ratio (Nlr)mentioning

confidence: 97%

A Rosetta Stone for Breast Cancer: Prognostic Value and Dynamic Regulation of Neutrophil in Tumor Microenvironment

et al. 2020

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Increasing evidence has revealed that the initiation and progression of breast cancer are greatly affected by the immune environment. Neutrophils are the most abundant leucocytes in circulation and act as the spearhead in inflammation, including in breast cancer. Circulating neutrophils are closely related to the prognosis of breast cancer patients, and tumor-infiltrating neutrophils have varied functions at different stages of breast cancer, such as antitumor or tumor-promoting neutrophils, which are termed N1 and N2 neutrophils, respectively. In this review, we will discuss the utility of circulating neutrophils for predicting prognosis and therapeutic efficacy and the underlying mechanisms of their chemotaxis, the dynamic regulation of their antitumor or protumor functions and their different spatial distributions in tumor microenvironment. Finally, we also discuss the possibility of targeting neutrophils as a therapeutic strategy in breast cancer.

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Increased derived neutrophil-to-lymphocyte ratio and Breast Imaging-Reporting and Data System classification predict poor survival in patients with non-distant metastatic HER2+ breast cancer treated with neoadjuvant chemotherapy

Cited by 12 publications

References 48 publications

<p>Increased systemic immune-inflammation index independently predicts poor survival for hormone receptor-negative, HER2-positive breast cancer patients</p>

<p>Increased systemic immune-inflammation index independently predicts poor survival for hormone receptor-negative, HER2-positive breast cancer patients</p>

Predictability of early changes in derived neutrophil-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio in patients with advanced non-small cell lung cancer treated with immune checkpoint inhibitors

A Rosetta Stone for Breast Cancer: Prognostic Value and Dynamic Regulation of Neutrophil in Tumor Microenvironment

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