Neutrophil-to-lymphocyte ratio predicts early mortality in females with metastatic triple-negative breast cancer

Abstract

Background The aim of this study was to determine the utility of the neutrophil-to-lymphocyte ratio (NLR) as a biomarker for predicting early-mortality (<2 years) among females with metastatic triple-negative breast cancer (mTNBC). Methods We reviewed 118 medical records of females with mTNBC. The cut-off value for the NLR (<2.5 and ≥2.5) was determined with receiver operating characteristic curves (area under the curve: 0.73; 95% CI: 0.62–0.85). Survival curves were estimated using the Kaplan-Meier method and compared with the Log-rank test. Multivariate Cox regression was used to identify the risk of mortality at two years. Moreover, we performed sensitivity analyses with different cut-off values and a subgroup analysis in females that only received chemotherapy. Results The median follow-up was 24 months. Females with NLR ≥2.5 had a poor overall survival compared to females with NLR <2.5 (6% vs. 28%, p<0.001) at two years. This outcome remained when we stratified for females that only received chemotherapy (8% vs. 36%, p = 0.001). Multivariate analyses identified NLR ≥2.5 as a poor prognostic risk factor for mortality in the entire population (HR: 2.12, 95% CI: 1.32–3.39) and among females that received chemotherapy (HR: 2.68, 95% CI: 1.46–4.92). Conclusion The NLR is an accessible and reliable biomarker that predicts early mortality among females with mTNBC. Our results suggest that females with high NLR values have poor prognosis despite receiving standard chemotherapy. Health providers should evaluate the possibility to enroll these patients in novel immunotherapy trials.

Pretreatment neutrophil to lymphocyte ratio as prognostic factor in metastatic breast cancer treated with cyclin dependent kinase 4/6 inhibitors

“…( 25 ) reported an association between high NLR and worse OS in 2,374 eBC and mBC patients, for patients with luminal subtypes. In another study concerning mTNBC, NLR> 2.5 at diagnosis was a useful predictor of poor OS, regardless of the subsequent treatment ( 26 ). In HR+/HER2- eBC, high NLR (>2.25) after neoadjuvant chemotherapy was correlated with poorer disease free survival (DFS) and OS, especially in patients with non-pathologic complete response (pCR) ( 15 ).…”

Association of Neutrophil to Lymphocyte Ratio with Clinicopathological Features in Breast Cancer

“…The Association of NLR is calculated with outlined clinic-pathological features of breast cancer by using the chi-square test and the P-value of less than 0.05 is considered significant. The cut-off value for the NLR ratio is 2.5 as quoted by other authors [14,15] Univariate logistics regression was applied for variables found significant by the chisquare test.…”

Correlation between the neutrophil-to-lymphocyte ratio and clinicopathological parameters in epithelial ovarian cancer patients and its effect on prognosis—a retrospective cohort study

“…Identifying risk factors for postoperative recurrence, metastasis, or death in ovarian cancer patients is beneficial for improving treatment measures to prolong the survival and predict the prognosis of these patients. In recent years, the relationship between the neutrophil-to-lymphocyte ratio (NLR) and malignant tumors has gradually attracted increasing attention from scholars, and studies have confirmed that NLR can predict patient prognosis in breast, liver, lung, and bladder cancers, these studies showed that a higher level of NLR was associated with a poor prognosis (5)(6)(7)(8). Studies have also shown that NLR is associated with the efficacy of neoadjuvant chemotherapy in patients with ovarian cancer, a higher level of NLR is associated with a poor efficacy of neoadjuvant chemotherapy (9,10), but whether this change in efficacy translates into a long-term mortality benefit is unclear.…”