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. 2023 Sep 15:15:17588359231193732.
doi: 10.1177/17588359231193732. eCollection 2023.

Low neutrophil-to-lymphocyte ratio and pan-immune-inflammation-value predict nodal pathologic complete response in 1274 breast cancer patients treated with neoadjuvant chemotherapy: a multicenter analysis

Maria Luisa Gasparri  1   2 , Sara Albasini  3 , Marta Truffi  3 , Karin Favilla  4 , Barbara Tagliaferri  3 , Francesca Piccotti  3 , Daniela Bossi  3 , Giulia Armatura  5 , Arianna Calcinotto  6   7 , Corrado Chiappa  8 , Francesca Combi  9   10 , Annalisa Curcio  11 , Angelica Della Valle  12 , Guglielmo Ferrari  13 , Secondo Folli  14 , Matteo Ghilli  15 , Chiara Listorti  14 , Stefano Mancini  16 , Peter Marinello  5 , Simone Mele  13 , Anna Pertusati  16 , Manuela Roncella  15 , Lorenzo Rossi  2   17 , Francesca Rovera  8 , Silvia Segattini  10 , Adele Sgarella  18   19 , Daniela Tognali  11 , Fabio Corsi  20   21
Affiliations

Low neutrophil-to-lymphocyte ratio and pan-immune-inflammation-value predict nodal pathologic complete response in 1274 breast cancer patients treated with neoadjuvant chemotherapy: a multicenter analysis

Maria Luisa Gasparri et al. Ther Adv Med Oncol. .

Abstract

Background: Systemic inflammatory markers draw great interest as potential blood-based prognostic factors in several oncological settings.

Objectives: The aim of this study is to evaluate whether neutrophil-to-lymphocyte ratio (NLR) and pan-immune-inflammation value (PIV) predict nodal pathologic complete response (pCR) after neoadjuvant chemotherapy (NAC) in node-positive (cN+) breast cancer (BC) patients.

Design: Clinically, cN+ BC patients undergoing NAC followed by breast and axillary surgery were enrolled in a multicentric study from 11 Breast Units.

Methods: Pretreatment blood counts were collected for the analysis and used to calculate NLR and PIV. Logistic regression analyses were performed to evaluate independent predictors of nodal pCR.

Results: A total of 1274 cN+ BC patients were included. Nodal pCR was achieved in 586 (46%) patients. At multivariate analysis, low NLR [odds ratio (OR) = 0.71; 95% CI, 0.51-0.98; p = 0.04] and low PIV (OR = 0.63; 95% CI, 0.44-0.90; p = 0.01) were independently predictive of increased likelihood of nodal pCR. A sub-analysis on cN1 patients (n = 1075) confirmed the statistical significance of these variables. PIV was significantly associated with axillary pCR in estrogen receptor (ER)-/human epidermal growth factor receptor 2 (HER2)+ (OR = 0.31; 95% CI, 0.12-0.83; p = 0.02) and ER-/HER2- (OR = 0.41; 95% CI, 0.17-0.97; p = 0.04) BC patients.

Conclusion: This study found that low NLR and PIV levels predict axillary pCR in patients with BC undergoing NAC.

Registration: Eudract number NCT05798806.

Keywords: axillary dissection; axillary surgery; breast cancer; inflammatory markers; neutrophil–lymphocyte ratio; pan-immune-inflammation value; sentinel lymph node biopsy.

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Conflict of interest statement

The authors declare that there is no conflict of interest.

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