Roles of neutrophil/lymphocyte ratio in prognosis and in differentiation of potential beneficiaries in HER2-positive breast cancer with trastuzumab therapy

Abstract

Background: The relationship of neutrophil/lymphocyte ratio (NLR) to prognosis of HER2-positive breast cancer (BC) is not well studied. We aimed to assess the prognostic role of NLR in HER2-positive BC patients treated with or without trastuzumab. Methods: The clinical data of 843 HER2-positive BC patients from July 2013 to July 2018 were collected. The difference among variables was calculated by chi-square test. The associations between clinicopathological factors, NLR and disease-free survival (DFS) were analyzed by univariate and multivariate analyses. Results: Patients were divided into three groups. In group 1 containing 255 patients without trastuzumab treatment, pretreatment NLR showed no predictive value. Patients with trastuzumab treatment were divided into two groups on equal, according to pretreatment NLR values, low NLR (group 2) and high NLR (group 3). Patients in group 2 showed significantly higher 3-year DFS rate than patients in group 1 and group 3 (95.3% vs. 91.6% vs. 90.5%, respectively, P = 0.011); patients in the group 1 and group 3 had a similar 3-year DFS outcome. Multivariate analysis showed high pretreatment NLR was significantly associated with shorter DFS (HR = 2.917, 95% CI = 1.055-8.062, P = 0.039) in HER2-positive BC patients treated with trastuzumab. Conclusions: Among HER2-positive trastuzumab-treated BC patients, low pretreatment NLR value was associated with better DFS, and it might help to differentiate potential beneficiaries of trastuzumab treatment.

The prognostic and predictive role of the neutrophil-to-lymphocyte ratio and the monocyte-to-lymphocyte ratio in early breast cancer, especially in the HER2+ subtype

“…One recent retrospective study has compared the prognostic value of the NLR among HER2+ patients treated with or without adjuvant trastuzumab [16]. In contrast to our results, NLR was not prognostic among HER2+ patients treated without trastuzumab but showed prognostic value among the patients with 1-year adjuvant trastuzumab.…”

“…In contrast to our results, NLR was not prognostic among HER2+ patients treated without trastuzumab but showed prognostic value among the patients with 1-year adjuvant trastuzumab. The difference in the 3-year DFS rate was rather small, 95.3% vs. 90.5% for low and high NLR groups, respectively, with a rather short median follow-up time of 20 months [16]. In our study, with a long follow-up time (median 10.4 years), the prognostic impact of both NLR and MLR according to OS, BCSS and distant relapse rate was found among the HER2+ patients treated without adjuvant trastuzumab but not among those who did receive trastuzumab.…”

“…Indeed, high levels of tumor infiltrating lymphocytes (TILs) have been shown to associate with a better response to trastuzumab in HER2+ BC [ 13 ]. There are only a few studies investigating the possible predictive role of the blood inflammatory cells in HER2+ BC treated with trastuzumab, and the results have been conflicting [ 14 – 16 ].…”

Prognostic Significance of Neutrophil-to-Lymphocyte Ratio and C-Reactive Protein/Albumin Ratio in Luminal Breast Cancers With HER2-Negativity

“…Tiainen et al (13) found that among the HER-2+ patients without trastuzumab therapy as adjuvant treatment, the survival rates of patients with high NLR were significantly lower compared with those with low NLR. On the contrary, Ding et al (14) found that NLR did not have prognostic value among HER-2+ patients without trastuzumab treatment, yet could predict the prognosis of those who received trastuzumab treatment for 1 year. Additionally, the 3-year DFS of the low NLR group was also found to be significantly higher than that of the high NLR group (95.3% vs 90.5%, P=0.011).…”

An Applicable Inflammation-Joined and Nutrition-Related Prognostic Indicator in Patients With Colorectal Cancer

“…The inclusion criteria were as follows: (a) patients with histologically confirmed CRC; (b) patients who underwent primary tumor resection; and (c) patients who had no treatment prior to the blood test. The exclusion criteria were as follows: (a) familial adenomatous polyposis or hereditary colon cancer; (b) there were no signs of clinical infection such as fever on the day of blood collection (28), and (c) patients with other neoplastic diseases during the same period. Baseline clinicopathologic parameters, including general basic information; past, personal, and family history; preoperative and postoperative blood routine examination; serological markers and inflammation-related indicators; enhanced computed tomography (CT) and MRI; degree of histological differentiation and pathological TNM staging; KRAS and BRAF V600E mutation status and microsatellite instability (MSI) testing; and preoperative and postoperative adjuvant chemoradiotherapy, were derived from the medical records.…”