Low neutrophil-to-lymphocyte ratio and pan-immune-inflammation-value predict nodal pathologic complete response in 1274 breast cancer patients treated with neoadjuvant chemotherapy: a multicenter analysis

Abstract

Background: Systemic inflammatory markers draw great interest as potential blood-based prognostic factors in several oncological settings. Objectives: The aim of this study is to evaluate whether neutrophil-to-lymphocyte ratio (NLR) and pan-immune-inflammation value (PIV) predict nodal pathologic complete response (pCR) after neoadjuvant chemotherapy (NAC) in node-positive (cN+) breast cancer (BC) patients. Design: Clinically, cN+ BC patients undergoing NAC followed by breast and axillary surgery were enrolled in a multicentric study from 11 Breast Units. Methods: Pretreatment blood counts were collected for the analysis and used to calculate NLR and PIV. Logistic regression analyses were performed to evaluate independent predictors of nodal pCR. Results: A total of 1274 cN+ BC patients were included. Nodal pCR was achieved in 586 (46%) patients. At multivariate analysis, low NLR [odds ratio (OR) = 0.71; 95% CI, 0.51–0.98; p = 0.04] and low PIV (OR = 0.63; 95% CI, 0.44–0.90; p = 0.01) were independently predictive of increased likelihood of nodal pCR. A sub-analysis on cN1 patients ( n = 1075) confirmed the statistical significance of these variables. PIV was significantly associated with axillary pCR in estrogen receptor (ER)−/human epidermal growth factor receptor 2 (HER2)+ (OR = 0.31; 95% CI, 0.12–0.83; p = 0.02) and ER−/HER2− (OR = 0.41; 95% CI, 0.17–0.97; p = 0.04) BC patients. Conclusion: This study found that low NLR and PIV levels predict axillary pCR in patients with BC undergoing NAC. Registration: Eudract number NCT05798806.

Peripheral blood inflammatory indexes in breast cancer: A review

“…[ 110 ] And, the results of a recent multicenter study involving 1274 patients treated with NAC also confirmed that low PIV independently predicts an increased likelihood of lymph node pCR. [ 80 ] In operable breast cancer patients, PIV showed the same results for predicting prognosis. [ 111 ] Another retrospective study including 57 patients with HER2-positive breast cancer showed that high PIV was associated with poorer PFS and OS in patients treated with first-line taxane-trastuzumab-pertuzumab.…”

“…In addition, NLR has been found to predict axillary nodal pathologic complete response after neoadjuvant therapy for breast cancer. [ 79 , 80 ]…”

Associations between pan-immune-inflammation value and abdominal aortic calcification: a cross-sectional study

“…type in peripheral blood and potentially reflect the systemic inflammatory conditions. Recent years, the focus of PIV-related research has mainly centered on its implications for the prognosis and therapeutic outcomes in oncological patients (11,12,(18)(19)(20)(21)(22)(23) (20). Furthermore, PIV has also been discovered as a novel biomarker in reflecting the association between inflammation and noncancer diseases, such as in hypertension, heart failure, myocardial infarction, kidney disease, frailty, and hepatic steatosis (13,(24)(25)(26)(27)(28).…”