Lymphocyte-to-Monocyte Ratio is Associated with the Poor Prognosis of Breast Cancer Patients Receiving Neoadjuvant Chemotherapy

Ma, Youzhao; Zhang, Jingyang; Chen, Xiuchun

doi:10.2147/cmar.s292048

Cited by 41 publications

(38 citation statements)

References 39 publications

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“…Concerning LMR, it was associated with poor OS in a meta-analysis of patients with solid tumors [42]. In the BC neoadjuvant chemotherapy setting, a recent study con rmed this result in a multivariable analysis and showed that patients with low LMR had shorter DFS [43].…”

Section: Discussionmentioning

confidence: 89%

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

Rottier

SILVA

Johnson

et al. 2022

Preprint

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Background: Cyclin dependent kinase inhibitors (CdK4/6i) changed the course of hormone receptor positive (HR+) HER2negative (HER2-) metastatic breast cancer (mBC). To date, no factors have been shown to predict response to CdK4/6i. Neutrophil-to-lymphocyte ratio (NLR), an indicator of the host systemic inflammatory response, is an independent prognostic factor for survival in cancers. We conducted this study to evaluate the addition of NLR for survival assessment in mBC patients treated with first line CdK4/6i. Methods: All mBC patients treated with first line CdK4/6i between November 2015 and December 2019 were retrospectively included. We analyzed 12-month progression free survival (PFS), overall survival (OS) and response rate according to NLR in univariable and multivariable analysis.Results: A total of 126 patients treated with palbociclib (n=101), ribociclib (n=18) or abemaciclib (n=7) were included, with a median follow-up of 16 months [range: 2.9-37]. Median age was 65 years [29-86], 88% patients had good performance status (0-1). Most patients were included at the metastatic relapse stage (71%) and 20% had visceral metastases without bone lesions. High NLR (≥ 2.53) was significantly associated with worse PFS (Hazard Ratio (HR)=0.52, CI95% =[0.29-0.94]). Fourteen patients died (11.1%). Complete responses were more frequent in the low NLR group (<2.53) (14.5% vs. 3.1%, p=0.029). Conclusion: High NLR is associated with worse PFS in HR+ HER2- mBC patients treated with first line CdK4/6i. NLR is a reliable and inexpensive prognostic marker, easily accessible in routine clinical practice, which could optimize the therapeutic strategy. These results need to be confirmed in larger prospective studies.

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Section: Discussionmentioning

confidence: 89%

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

Rottier

SILVA

Johnson

et al. 2022

Preprint

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“…We have collected baseline counts of neutrophil-lymphocyte and monocytes and platelets for peripheral blood parameters to calculate our inflammatory indices (NLR, LMR, and PLR). Cut-off points for NLR, LMR, and PLR were obtained from a similar study that documented the optimal ratio of 3%, 6.2%, 135%, respectively (Ma et al, 2021). For RDW, we have used a range from a focused study on breast cancer (11-14.1) (Seretis et al, 2013).…”

Section: Methodsmentioning

confidence: 99%

Prognostic value of pre-treatment inflammatory markers in patients with locally advanced breast cancer (LABC) from Saudi Arabia

Abusanad¹,

Alghamdi²,

Saggaf³

et al. 2022

Medical Science

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Background: Inflammation is a recognized factor in cancer progression and resistance to treatments. Several studies correlated inflammatory-related peripheral blood indices to disease progression and poor survival in various cancer types and different populations. Nonetheless, inflammation is affected by the distinctive characteristics and environmental exposure of each people. Methods: We retrospectively analyzed the data of female patients with LABC undergoing neoadjuvant chemotherapy (NACT). Demographics, BMI, clinicopathologic characteristics, stage of the tumor, follow-up status, and response to treatment were collected. Outcomes were evaluated concerning the high and low groups of inflammatory markers based on the cut-off values of NLR and RDW. Results: A total of 172 patients met the eligibility criteria among patients diagnosed with breast cancer (BC) from January 2014 to December 2020. At the time of diagnosis, the mean age was (53.4± 11), BMI was (31.2 ± 6). Left BC accounted (54.7%) and the majority were moderately differentiated (51.2%), and ductal carcinoma (85.5%), ER-positive tumor in (79.1%), HER2-positive in (32%), TNBC in (9.8%). Only normal RDW and Low NLR were significantly associated with a type of response post NACT with P values (0.003) and (0.014) respectively, with significant response type complete remission (71.5%) based on the radiological evaluation. Conclusion: RDW and NLR could be applicable biomarkers to predict response after systemic therapy among LABC. The great advantage of these biomarkers depends on routine tests before treatment, and it is cost-effective in the diagnostic plan.

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“…[12][13][14][15] In terms of breast cancer, several studies have shown that inflammatory-nutritional indexes, including the platelet-lymphocyte ratio (PLR), systemic inflammation score (SIS), neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), Controlling Nutritional Status (CONUT), and systemic immune-inflammation index (SII), are markedly associated with survival outcomes. [16][17][18][19][20][21] Qi et al first recognized the system inflammation response index (SIRI) as a predictor for pancreatic cancer. The prognostic value of this index in patients with breast cancer was also explored in our previous study.…”

Section: Introductionmentioning

confidence: 99%

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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Lymphocyte-to-Monocyte Ratio is Associated with the Poor Prognosis of Breast Cancer Patients Receiving Neoadjuvant Chemotherapy

Cited by 41 publications

References 39 publications

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

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

Prognostic value of pre-treatment inflammatory markers in patients with locally advanced breast cancer (LABC) from Saudi Arabia

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

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