Prognostic implications of the peripheral platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio in predicting pathologic complete response after neoadjuvant chemotherapy in breast cancer patients

Abstract

Background: The inflammatory response is extremely important in tumor progression, and it is very difficult to identify prognostic indicators for neoadjuvant therapy in breast cancer patients. The aim of this study was to mine the potential prognostic significance of the platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) in breast cancer patients receiving anthracycline-or taxane-based neoadjuvant chemotherapy (NACT).Methods: A total of 67 women diagnosed with breast cancer who received neoadjuvant therapy were enrolled in the study. Before starting NACT, the PLR and NLR were calculated. The optimal cutoff value was calculated using receiver operating characteristic (ROC) curve analyses, which indicated that 106.3 and 2.464 were the best cutoff values for the PLR and NLR, respectively. The optimal cutoff values for them were used to divide patients into low and high NLR groups and low and high PLR groups. Independent prognostic biomarkers and the value of PLR and NLR were assessed. The connection between the NLR/PLR and pathologic complete response (pCR), together with other clinical/pathological factors was evaluated.Results: Logistic regression model analyses revealed that patients with a high PLR correlated remarkably with better pCR than those with a low PLR. The results indicated that by using the cutoff value of 106.3, PLR had prognostic significance. However, there was no significant difference in NLR if analyzed separately.By combining PLR and NLR, the NLRhigh and PLRhigh subgroups achieved a significantly higher rate of pCR than the NLRIow/PLRIow subgroup [odds ratio (OR) 0.153, 95% confidence interval (CI): 0.068 to 0.876, P=0.008]. Therefore, the combination of NLRhigh/PLRhigh was an independent prognostic factor different from others, such as PLR, Ki-67, and chemotherapy regimen. Conclusions:The PLR may serve as a potential marker of the efficacy of neoadjuvant therapy in breast cancer, enabling oncologists to intervene earlier. Peripheral blood NLR and PLR can reflect the immune status of patients. Indicating that an immunogenic phenotype is a good predictor of chemotherapy response and that combined studies can better identify immunophenotypes in patients.

A nomogram based on platelet-to-lymphocyte ratio for predicting pathological complete response of breast cancer after neoadjuvant chemotherapy

“…However, another study suggested that there was no significant correlation between the level of PLR and the rate of pCR [19]. Previous study even suggested that the higher the PLR value of patients before NAC, the greater the probability of acquiring pCR [18]. Our study showed that there was a significant difference in PLR value between the pCR group and the Non-pCR group, and the PLR was significantly lower in the pCR group.…”

“…In addition, PLR was an independent factor for predicting pCR after NAC for BC, and patients with low PLR achieved higher pCR rates [15][16][17]. However, another study showed that patients with high PLR had higher pCR rates than those with low PLR [18]. It was also reported that there was no significant correlation between PLR and pCR [19].…”

The Association between a Decrease in On-Treatment Neutrophil-to-Eosinophil Ratio (NER) at Week 6 after Ipilimumab Plus Nivolumab Initiation and Improved Clinical Outcomes in Metastatic Renal Cell Carcinoma

“…There are several limitations in the current study. First, several peripheral blood count-based biomarkers have been previously investigated in various cancers, before and after the advent of ICIs, such as the neutrophil-to-lymphocyte ratio [ 52 , 53 , 54 , 55 , 56 ], lymphocyte-to-monocyte ratio [ 52 , 55 , 57 ], and platelet-to-lymphocyte ratio [ 52 , 54 , 58 , 59 , 60 ]. The current study chose to investigate NER (instead of other indices) based on our clinical observation of eosinophil count elevation and the established prognostic role of neutrophilia in mRCC in the IMDC model [ 27 ].…”

Prognostic value of neutrophil‐to‐lymphocyte ratio in gastric cancer patients treated with immune checkpoint inhibitors: A meta‐analysis

“…Growing evidence has shown that immune responses play a pivotal role in cancer progression and development 7 . A series of blood‐derived parameters have been demonstrated to be effective prognostic markers for solid tumors 8 . These indices include the platelet‐to‐lymphocyte ratio, 9 systemic immune‐inflammation index, 10 lymphocyte‐to‐monocyte ratio, 11 and neutrophil‐to‐lymphocyte ratio (NLR) 12 .…”

“…7 A series of blood-derived parameters have been demonstrated to be effective prognostic markers for solid tumors. 8 These indices include the platelet-to-lymphocyte ratio, 9 systemic immune-inflammation index, 10 lymphocyte-to-monocyte ratio, 11 and neutrophil-to-lymphocyte ratio (NLR). 12 NLR is calculated as the neutrophil count divided by lymphocyte count in peripheral blood.…”