The pan-immune-inflammation value is associated with clinical outcomes in patients with advanced TNBC treated with first-line, platinum-based chemotherapy: an institutional retrospective analysis

Abstract

Background: Advanced triple-negative breast cancer (aTNBC) has a poor prognosis; thus, there is a need to identify novel biomarkers to guide future research and improve clinical outcomes. Objectives: We tested the prognostic ability of an emerging, complete blood count (CBC)-based inflammatory biomarker, the pan-immune-inflammation value (PIV), in patients with aTNBC treated with first-line, platinum-based chemotherapy. Design: This was a retrospective, monocentric, observational study. Methods: We included consecutive aTNBC patients treated with platinum-based, first-line chemotherapy at our Institution, and for whom baseline (C1) CBC data were available. We collected CBC data early on-treatment, when available. PIV was calculated as: (neutrophil count × platelet count × monocyte count)/lymphocyte count. Patients with hormone receptor-positive (HR+), human epidermal growth factor receptor 2 (HER2)-negative advanced breast cancer (aBC) were included in a control, non-TNBC cohort. Results: A total of 78 aTNBC patients were included. When evaluated as a continuous variable, PIV-C1 was associated with worse overall survival (OS; p < 0.001) and progression-free survival (PFS; p < 0.001). On the other hand, when PIV-C1 was assessed on the basis of its quantile distribution, patients with ‘high PIV-C1’ experienced worse OS [adjusted hazard ratio (HR): 4.46, 95% confidence interval (CI): 2.22–8.99; adjusted p < 0.001] and PFS (adjusted HR: 2.03, 95% CI: 1.08–3.80; adjusted p = 0.027) when compared to patients with ‘low PIV-C1’. Higher PIV-C1 was also associated with primary resistance to chemotherapy. Similarly, a higher PIV calculated from CBC at C2D1 (PIV-C2) was associated with worse survival outcomes. We also created a PIV-based score combining information about both PIV-C1 and PIV-C2 and allowing the stratification of patients at low, intermediate, and high risk of death. No association was observed between PIV-C1 and clinical outcomes of HR+/HER2− aBC patients. Conclusion: PIV has a promising prognostic discrimination ability in aTNBC patients treated with first-line, platinum-based chemotherapy. Both baseline and early on-treatment PIV are associated with clinical outcomes and may be exploited for creating PIV-based risk classifiers if further validated.

Clinical utility of the pan-immune-inflammation value in breast cancer patients

“…The remaining 20 articles' entire texts were then assessed in further detail. There were 8 articles involving 2953 patients (21,22,(27)(28)(29)(30)(31)(32). Figure 1 displays the PRISMA flowchart.…”

Association of immune inflammatory biomarkers with pathological complete response and clinical prognosis in young breast cancer patients undergoing neoadjuvant chemotherapy

“…A meta-analysis demonstrated that colorectal tumor patients in the high pretreatment PIV group had poor OS and progression-free survival ( 40 ). Several researches supported the predictive role of PIV in breast cancer ( 15 , 41 ). Among a population of patients with advanced triple-negative breast cancer undergoing platinum-based chemotherapy, Provenzano et al.…”

“…Among a population of patients with advanced triple-negative breast cancer undergoing platinum-based chemotherapy, Provenzano et al. found that both the baseline and initial on-treatment PIV correlate with OS ( 41 ). Our study also demonstrated that PIV was significantly related to pCR and OS in breast cancer patients undergoing NACT.…”

Associations between pan-immune-inflammation value and abdominal aortic calcification: a cross-sectional study

“…Meanwhile, Provenzano et al. retrospectively analyzed the association between increased PIV and adverse outcomes, including worse overall survival (HR: 4.46, 95%CI: 2.22-8.99) and progression-free survival (HR: 2.03, 95% CI: 1.08-3.80), besides, resistance to platinum-based chemotherapy in patients with advanced triple-negative breast cancer ( 20 ). Furthermore, PIV has also been discovered as a novel biomarker in reflecting the association between inflammation and noncancer diseases, such as in hypertension, heart failure, myocardial infarction, kidney disease, frailty, and hepatic steatosis ( 13 , 24 – 28 ).…”

“…type in peripheral blood and potentially reflect the systemic inflammatory conditions. Recent years, the focus of PIV-related research has mainly centered on its implications for the prognosis and therapeutic outcomes in oncological patients (11,12,(18)(19)(20)(21)(22)(23) (20). Furthermore, PIV has also been discovered as a novel biomarker in reflecting the association between inflammation and noncancer diseases, such as in hypertension, heart failure, myocardial infarction, kidney disease, frailty, and hepatic steatosis (13,(24)(25)(26)(27)(28).…”