Pretreatment systemic inflammation response index is predictive of pathological complete response in patients with breast cancer receiving neoadjuvant chemotherapy

Abstract

Background Inflammation plays an important role in tumor proliferation, metastasis, and resistance to chemotherapy. The systemic inflammation response index (SIRI), has been reported to be closely related to prognosis in many tumors, such as breast and gastric cancers. However, the predictive value of pretreatment SIRI on pathological complete response (pCR) rates in patients with breast cancer treated with neoadjuvant chemotherapy (NAC) is unknown. This study examined the correlation between SIRI and pCR in patients with breast cancer receiving NAC and identified convenient and accurate predictive indicators for pCR. Methods We retrospectively analyzed the clinicopathological parameters and pretreatment peripheral blood characteristics of the 241 patients with breast cancer who received NAC between June 2015 and June 2020. Receiver operating characteristic (ROC) curves were used to determine the optimal cutoff of SIRI. ROC curves were also plotted to verify the accuracy of inflammatory markers for pCR prediction. The chi-squared test was used to explore the relationships of SIRI with pCR and other clinicopathological parameters. Multivariate analyses were performed using a logistic regression model. Results Among the 241 patients, 48 (19.92%) achieved pCR. pCR was significantly related to SIRI, the neutrophil-lymphocyte ratio (NLR), the lymphocyte-monocyte ratio (LMR), molecular subtypes and other clinicopathological parameters, such as BMI, clinical T and N staging, and histological grade. Multivariate analyses indicated that the clinical T and N staging, SIRI, and NLR were independent prognostic factors for pCR in patients with breast cancer. The area under the ROC curve for SIRI was larger than that for NLR. Compared to patients with SIRI ≥0.72, patients with SIRI < 0.72 had a nearly 5-fold higher chance of obtaining pCR (odds ratio = 4.999, 95% confidence interval = 1.510–16.551, p = 0.000). Conclusions Pretreatment SIRI is predictive of pCR in patients with breast cancer receiving NAC, and the index can assist physicians in formulating personalized treatment strategies.

Pegylated Liposomal Doxorubicin, Docetaxel, and Trastuzumab as Neoadjuvant Treatment for HER2-Positive Breast Cancer Patients: A Phase II and Biomarker Study

“…However, patients who had HR-negative status were more likely to achieve bpCR compared with those who had HR-positive status (76.2% vs. 48.3%, p = 0.047). Prior findings discovered that patients with high Ki-67 level, small tumor size, or low clinical stage have better access to get pCR (33)(34)(35). Due to the limited sample size, this study failed to co nfi r m t he c o r r e l a t i o n b e t w e e n tp C R a n d o t he r clinicopathological indicators.…”

Predictive value of NLR and PLR in response to preoperative chemotherapy and prognosis in locally advanced gastric cancer

“…Certain studies have affirmed the validity of a systemic immune-inflammation index in predicting pathological response and patient prognosis after NCT for breast cancer (19,20). Powell et al (21) have also reported an association between low pretreatment NLRs and good pathological responses in patients with esophageal cancer, and Caputo et al (22) have documented both poorer TRG and increased incidence of postoperative complications in patients with rectal cancers and high preoperative NLRs.…”

“…Certain studies have affirmed the validity of a systemic immune-inflammation index in predicting pathological response and patient prognosis after NCT for breast cancer ( 19 , 20 ). Powell et al.…”

The Systemic Inflammation Response Index as an Independent Predictor of Survival in Breast Cancer Patients: A Retrospective Study

“…Recent studies have confirmed that various markers of the systemic inflammatory response, for example, the C-reactive Protein (CRP), Platelet to Lymphocyte Ratio (PLR), Lymphocyte to Monocyte Ratio (LMR), and Neutrophil to Lymphocyte Ratio (NLR), all correlate to the prognosis of a myriad of tumors such as high-grade glioma ( He et al, 2021b ), colorectal cancer ( Dagmura et al, 2021 ), head and neck cancer ( Saroul et al, 2021 ), oral squamous cell cancer ( Yamagata et al, 2021 ), and gastric cancer ( Liu et al, 2021 ). The latest evidence also suggests that a similar tumor-inflammation relationship exists for breast cancer, indicating that quantifying the inflammatory response may be useful in treating and prognosticating breast cancer ( Dong et al, 2021 ). Common blood indices, including platelets (P), monocytes (M), neutrophils (N), hemoglobin (Hb), total red blood cell count (R), total white blood cell count (WBC), and serum albumin (ALB), along with its derivatives, NLR, MLR, LMR, PLR, D-NLR, prognostic nutritional value [PNI, 10 × serum ALB (g/dL) + 0.005 × total lymphocyte count], and SIRI (Neutrophil × Platelet/Lymphocyte) may all be reflective of malignant tumor states ( Mantovani et al, 2008 ).…”