The role of laboratory indices on treatment response and survival in breast cancer receiving neoadjuvant chemotherapy
Sedat Yıldırım, Akif Doğan, Goncagül Akdağ, Zeynep Yüksel Yaşar, Hamit Bal, Oğuzcan Kınıkoğlu, Sıla Öksüz, Uğur Özkerim, Salih Tünbekici, Hacer Şahika Yıldız, Özkan Alan, Şermin Çoban Kökten, Deniz Işık, Heves Sürmeli, Tuğba Başoğlu, Özlem Nuray Sever, Hatice Odabaş, Mahmut Emre Yıldırım, Nedim Turan
Abstract
Neoadjuvant chemotherapy (NACT) is the standard treatment for locally advanced, high-risk breast cancer. Pathological complete response (pCR) improves survival. Peripheral blood-derived indices reflecting systemic inflammation and nutritional status have long been used as predictive and prognostic markers in solid malignancies. This retrospective study investigates whether eight commonly used indices in patients receiving NACT affect pCR and survival. This study includes 624 locally advanced breast cancer patients who received NACT. The biomarker indices were calculated from peripheral blood samples taken two weeks before starting chemotherapy. The indices' optimal cut-off values were determined using ROC Curve analysis. During a median follow-up period of 42 months, recurrence was detected in 146 patients, and 75 patients died. pCR was observed in 166 patients (26.6%). In univariate analysis, NLR, PLR, SII, PNI, HALP, and HRR were statistically significantly associated (p = 0.00; p = 0.03; p = 0.03; p = 0.02; p = 0.00; p = 0.02 respectively), but in multivariate analysis, only NLR was significantly predictive for pCR(p = 0.04). In multivariate analysis, the HGB/RDW score significantly predicted DFS(p = 0.04). The PNI score was identified as a marker predicting survival for both OS and PFS (p = 0.01, p = 0.01, respectively). In conclusion, peripheral blood-derived indices have prognostic and predictive values on pCR and survival. However, further studies are needed to validate our findings.