Metabolic Syndrome Predicts Response to Neoadjuvant Chemotherapy in Breast Cancer

Abstract

PurposeThis research investigated the predictive role of metabolic syndrome (MetS) in breast cancer neoadjuvant chemotherapy (BCNACT) response.MethodsOne hundred fifty primary breast cancer (BC) patients who underwent neoadjuvant chemotherapy (NACT) were included retrospectively. MetS, MetS components [waist circumference (WC), fasting blood glucose (FBG), blood pressure, triglycerides (TG), and high-density lipoprotein cholesterol (HDL-C)], serum lipid, and other MetS-related laboratory indicators within two weeks before BCNACT were evaluated. Univariate, multivariate, and subgroup analyses were performed to determine the predictors of BCNACT pathologic complete response (pCR), clinical response, and pathologic response. The effectiveness of the model was evaluated via receiver operating characteristic curve (ROC) and calibration curve. External validation was performed through 135 patients.ResultsUnivariate analysis revealed that MetS before BCNACT predicted poor BCNACT response (pCR, P = 0.003; clinical response, P = 0.033; pathologic response, P < 0.001). Multivariate analysis confirmed that MetS before BCNACT predicted lower pCR rate (P = 0.041). Subgroup analysis showed that this relationship was significant in estrogen receptor (ER) (−) (RR = 0.266; 95% CI, 0.074–0.954), human epidermal growth factor 2 (HER2) (−) (RR = 0.833; 95% CI, 0.740–0.939) and TNBC (RR = 0.833; 95% CI, 0.636–0.995). Multivariate analysis of external validation confirmed that pretreatment MetS was associated with a lower pCR rate (P = 0.003), and subgroup analysis also confirmed that this relationship had significant statistical differences in ER (−), HER2 (−), and TNBC subgroups.ConclusionsMetS before BCNACT predicted a lower pCR rate. Intervention on MetS status, especially in ER (−), HER2 (−), and TNBC subgroups, is expected to improve the response rate of BCNACT further.

Breast Cancer Screening Awareness and Associated Factors Among Saudi Females: A Cross-Sectional Study in Jeddah, Saudi Arabia (2024)

“…Some studies have reported that dyslipidemia is a significant risk factor for the poor prognosis of BC [26]. A previous study has reported that dyslipidemia prior to chemotherapy intervention had a negative effect on the complete response rate of BC [27]. The exact role of dyslipidemia in BC remains poorly understood; however, a higher awareness level in this patient population is significant, which warrants further research to elucidate the role of dyslipidemia in BC.…”

Metabolic syndrome is a risk factor for breast cancer patients receiving neoadjuvant chemotherapy: A case-control study

“…The relationship between MetS and pCR in BC patients who underwent NAC was not consistent in previous studies. A study of 150 breast cancer neoadjuvant chemotherapy (BCNACT) patients which adopted International Diabetes Federation (IDF) criteria to diagnose MetS reported that MetS before BCNACT predicted a lower pCR rate (P=0.003) ( 31 ). Tong et al.…”

“…The relationship between MetS and pCR in BC patients who underwent NAC was not consistent in previous studies. A study of 150 breast cancer neoadjuvant chemotherapy (BCNACT) patients which adopted International Diabetes Federation (IDF) criteria to diagnose MetS reported that MetS before BCNACT predicted a lower pCR rate (P=0.003) (31). Tong et al found that in HER2-positive BC patients receiving neoadjuvant therapy, MetS showed a tendency to interfere with NAC effcacy, but the difference was not statistically significant in multivariate analysis (32).…”

Dyslipidemia is associated with a poor prognosis of breast cancer in patients receiving neoadjuvant chemotherapy

“…Some studies have shown that dyslipidemia is a high risk factor for the poor prognosis of breast cancer [ 6 , 7 ]. A past study reported that dyslipidemia before neoadjuvant chemotherapy affected the pathological complete response (pCR) rate of breast cancer [ 8 ]. However, other studies have suggested that baseline dyslipidemia is a good prognostic factor for breast cancer [ 9 , 10 ].…”