The Neutrophil to Lymphocyte Ratio Predicts the Response to Neoadjuvant Chemotherapy in Luminal B Breast Cancer

Document Type: Research Articles

Authors

1 Department of Hematology and Oncology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.

2 Department of Oncological and Maxillofacial Surgery, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.

3 Department of Anatomy and Pathology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.

4 Department of Radiology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.

5 Centro de Cancer, Red de Salud UC-CHRISTUS, Santiago, Chile.

6 Millennium Institute on Immunology and Immunotherapy, Department of Molecular Genetics and Microbiology, Faculty of Biologic Sciences, Pontificia Universidad Catolica de Chile, Santiago, Chile.

Abstract

Objective: Tumor response to neoadjuvant chemotherapy (NAC) in breast cancer (BC) patients is a predictor for
overall survival. The aim of our study was to determine a relationship between the neutrophil to lymphocyte ratio
(NLR) prior to NAC, BC subtypes and the probability of a pathologic complete response (pCR). Materials and
Methods: Medical records were collected retrospectively from Centro de Cancer at Red Salud UC-Christus. Clinical
data collected included peripheral blood cell counts, BC subtype at diagnosis and the pathology report of surgery
after chemotherapy. Results: A total of 88 patients were analyzed. Approximately, a 25% had a pCR, and displayed a
significant correlation between BC subtype and pCR (p= 0.0138 Chi2); this was more frequent in epidermal growth
factor receptor type 2 (HER2) enriched subtype patients (54%). Luminal B BC patients with a pCR had significantly
lower NLR levels (t test, p= 0.0181). Conclusions: HER2-enriched tumors had a higher probability of pCR. In Luminal
B tumors, NLR had a statistically significant relationship with the probability of pCR. In this subtype, NLR could be
a useful biomarker to predict tumor response to NAC. Further studies including other clinical parameters for systemic
inflammation such as platelet counts, intratumoral NLR or body mass index could help identify patients that would
get the most benefit from NAC.

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