Low pan-immune-inflammation-value predicts better chemotherapy response and survival in breast cancer patients treated with neoadjuvant chemotherapy

Şahin, Ahmet Bilgehan; Çubukçu, Erdem; Ocak, Birol; Adem, Deligonul; Orhan, Sibel; Tolunay, Şahsine; Gökgöz, Mustafa Şehsuvar; Çetintaş, Sibel Kahraman; Yarbas, Gorkem; Şenol, Kazım; Goktug, Mehmet Refik; Yanasma, Zeki Burak; Hasanzade, Ulviyya; Evrensel, Türkkan

doi:10.1038/s41598-021-94184-7

Cited by 74 publications

(95 citation statements)

References 41 publications

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“…For example, a high NLR is usually considered as an indicator of a poor prognosis, 19,38 but NLR failed to show independent value in the multivariate Cox analysis in other studies when identifying patients with a pathological complete response or achievement of disease-free status. 39,40 A similar dilemma has also been found in other biomarkers, such as MLR. These discrepancies could be attributed to patient heterogeneity, differences in the definitions of cutoff points, and so on.…”

Section: Discussionsupporting

confidence: 56%

A Novel Inflammatory-Nutritional Prognostic Scoring System for Patients with Early-Stage Breast Cancer

Hua¹,

Duan²,

Zhai³

et al. 2022

JIR

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Purpose We attempted to explore the prognostic value of baseline inflammatory and nutritional biomarkers at diagnosis in patients with early-stage breast cancer and develop a novel scoring system, the inflammatory-nutritional prognostic score (INPS). Patients and Methods We collected clinicopathological and baseline laboratory data of 1259 patients with early-stage breast cancer between December 2010 and November 2012 from Sun Yat-sen University Cancer Center. Eligible patients were randomly divided into training and validation cohorts (n = 883 and 376, respectively) in a 7:3 ratio. We selected the most valuable biomarkers to develop INPS by the least absolute shrinkage and selection operator (LASSO) Cox regression model. A prognostic nomogram incorporating INPS and other independent clinicopathological factors was developed based on the stepwise multivariate Cox regression method. Then, we used the concordance index (C-index), calibration plot, and time-dependent receiver operating characteristic (ROC) analysis to evaluate the prognostic performance and predictive accuracy of the predictive nomogram. Results Four inflammatory-nutritional biomarkers, including neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), prognostic nutritional index (PNI), and albumin-alkaline phosphatase ratio (AAPR), were selected using the LASSO Cox analysis to construct INPS, which remained an independent prognostic indicator per the multivariate Cox regression analysis. Patients were stratified into low- and high-INPS groups based on the cutoff INPS determined by the maximally selected rank statistics. The prognostic model for overall survival consisting of INPS and other independent clinicopathological indicators showed excellent discrimination with C-indexes of 0.825 (95% confidence interval [CI]: 0.786–0.864) and 0.740 (95% CI: 0.657–0.822) in the training and validation cohorts, respectively. The time-dependent ROC curves showed a higher predictive accuracy of our prognostic nomogram than that of traditional tumor-node-metastasis staging. Conclusion Baseline INPS is an independent indicator of OS in patients with early-stage breast cancer. The INPS-based prognostic nomogram could be used as a practical tool for individualized prognostic predictions.

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Section: Discussionsupporting

confidence: 56%

A Novel Inflammatory-Nutritional Prognostic Scoring System for Patients with Early-Stage Breast Cancer

Hua¹,

Duan²,

Zhai³

et al. 2022

JIR

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“…Fifteen studies encompassing 4942 patients were included in the meta-analyses [ 32 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 ]. The available studies were conducted on several tumors, including CRC, melanoma, breast cancer, and non-small cell lung cancer ( Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…One study evaluated both patients treated with immunotherapy (nivolumab and pembrolizumab alone) and targeted therapy with BRAF inhibitors/MEK inhibitors, and separate data for these treatment types were included in the subgroup analyses [ 32 ]. Ten studies included Caucasian patients [ 32 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 48 ], while five studies were conducted in the Far East [ 44 , 45 , 46 , 47 , 49 ]. Most studies had a low risk of bias according to the NOS ( Table 2 ).…”

Section: Resultsmentioning

confidence: 99%

“…Fourteen studies with available DFS/PFS data were included in the analyses [ 32 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 48 , 49 ]. All but two studies reported significantly lower DFS/PFS with higher PIV levels, while the DFS/PFS difference did not reach statistical significance in the studies by Guven et al and Susok et al [ 39 , 42 ].…”

Section: Resultsmentioning

confidence: 99%

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The Association between the Pan-Immune-Inflammation Value and Cancer Prognosis: A Systematic Review and Meta-Analysis

Güven

Şahin

Erul

et al. 2022

Cancers

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Background: Prognostic scores derived from the blood count have garnered significant interest as an indirect measure of the inflammatory pressure in cancer. The recently developed pan-immune-inflammation value (PIV), an equation including the neutrophil, platelet, monocyte, and lymphocyte levels, has been evaluated in several cohorts, although with variations in the tumor types, disease stages, cut-offs, and treatments. Therefore, we evaluated the association between survival and PIV in cancer, performing a systematic review and meta-analysis. Methods: We conducted a systematic review from the Pubmed, Medline, and Embase databases to filter the published studies until 17 May 2022. The meta-analyses were performed with the generic inverse-variance method with a random-effects model. Results: Fifteen studies encompassing 4942 patients were included. In the pooled analysis of fifteen studies, the patients with higher PIV levels had significantly increased risk of death than those with lower PIV levels (HR: 2.00, 95% CI: 1.51–2.64, p < 0.001) and increased risk of progression or death (HR: 1.80, 95% CI: 1.39–2.32, p < 0.001). Analyses were consistent across several clinical scenarios, including non-metastatic or metastatic disease, different cut-offs (500, 400, and 300), and treatment with targeted therapy or immunotherapy (p < 0.001 for each). Conclusion: The available evidence demonstrates that PIV could be a prognostic biomarker in cancer. However, further research is needed to explore the promise of PIV as a prognostic biomarker in patients with non-metastatic disease or patients treated without immunotherapy or targeted therapy.

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“…As PIV is a relatively novel biomarker, few studies on PIV have been reported thus far. A previous study ( 50 ) showed that a low PIV value predicts better chemotherapy response and survival in breast cancer patients treated with neoadjuvant chemotherapy. Another previous study ( 20 ) showed that PIV is a new and potent predictor of OS in HER-2-positive advanced BC patients treated with first-line trastuzumab–pertuzumab-containing biochemotherapy.…”

Section: Discussionmentioning

confidence: 99%

Pan-Immune-Inflammation Value: A New Prognostic Index in Operative Breast Cancer

et al. 2022

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BackgroundTo build a predictive scoring model based on simple immune and inflammatory parameters to predict postoperative survival in patients with breast cancer.MethodsWe used a brand-new immuno-inflammatory index—pan-immune-inflammation value (PIV)—to retrospectively evaluate the relationship between PIV and overall survival (OS), and based on the results of Cox regression analysis, we established a simple scoring prediction model based on several independent prognostic parameters. The predictive accuracy of the model was evaluated and independently validated.ResultsA total of 1,312 patients were included for analysis. PIV was calculated as follows: neutrophil count (109/L) × platelet count (109/L) × monocyte count (109/L)/lymphocyte count (109/L). According to the best cutoff value of PIV, we divided the patients into two different subgroups, high PIV (PIV > 310.2) and low PIV (PIV ≤ 310.2), associated with significantly different survival outcomes (3-year OS, 80.26% vs. 86.29%, respectively; 5-year OS, 62.5% vs. 71.55%, respectively). Six independent prognostic factors were identified and used to build the scoring system, which performed well with a concordance index (C-index) of 0.759 (95% CI: 0.715–0.802); the calibration plot showed good calibration.ConclusionsWe have established and verified a simple scoring system for predicting prognosis, which can predict the survival of patients with operable breast cancer. This system can help clinicians implement targeted and individualized treatment strategies.

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Low pan-immune-inflammation-value predicts better chemotherapy response and survival in breast cancer patients treated with neoadjuvant chemotherapy

Cited by 74 publications

References 41 publications

A Novel Inflammatory-Nutritional Prognostic Scoring System for Patients with Early-Stage Breast Cancer

A Novel Inflammatory-Nutritional Prognostic Scoring System for Patients with Early-Stage Breast Cancer

The Association between the Pan-Immune-Inflammation Value and Cancer Prognosis: A Systematic Review and Meta-Analysis

Pan-Immune-Inflammation Value: A New Prognostic Index in Operative Breast Cancer

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