121P - Prognostic significance of the derived neutrophil lymphocyte ratio in metastatic breast cancer: A tertiary cancer care center analysis from India

Date 18 December 2016
Event ESMO Asia 2016 Congress
Session Poster lunch
Topics Breast Cancer, Metastatic
Pathology/Molecular Biology
Presenter Chandan Das
Citation Annals of Oncology (2016) 27 (suppl_9): ix35-ix41. 10.1093/annonc/mdw577
Authors C.K. Das1, A. Gogia1, N.K. Shukla2, S. Deo2, S. Mathur3, D. Sharma4
  • 1Medical Oncology, All India Institute of Medical Sciences, 110029 - New Delhi/IN
  • 2Surgical Oncology, All India Institute of Medical Sciences, 110029 - New Delhi/IN
  • 3Pathology, All India Institute of Medical Sciences, 110029 - New Delhi/IN
  • 4Radiation Oncology, All India Institute of Medical Sciences, 110029 - New Delhi/IN

Abstract

Background

Derived neutrophil-lymphocyte ratio (dNLR) is a marker of systemic inflammatory response produced by proinflammatory cytokine activity of tumour microenvironment. dNLR is a simple, easily reproducible biomarker can be used to stratify the prognostic subgroups and decide the management in metastatic breast cancer. There is sparsity of data regarding derived neutrophil ratio in India. We evaluated dNLR as a prognostic biomarker in metastatic breast cancer patients treated at a North Indian tertiary cancer care centre.

Methods

We retrospectively reviewed the correlation between inflammatory biomarkers and clinical presentation and treatment outcome in 96 consecutively treated metastatic breast cancer patients between 2011-2014. Kaplan-Mere analysis done evaluate the impact on overall and progression-free survival.

Results

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Table: 121P

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ParametersResults
Duration of presentation9 months(1-120)
Metastatic sitebone: 59(60%), Lung:33(39%) liver: 22(22%)
Receptor statusER+/PR+HER2- 43(44%), ER+/PR+HER2  +++:18(18%), ER-PR-HER2 +++: 15(15%), TNBC: 22(23%)
Hemoglobin11.2 gm%(6.5-14.3)
TLC6700/mm3 (3520-27200)
ANC4412/mm3 (1090-11900)
TreatmentChemotherapy 79(81%), Surgery 43 (44%)
Response rateORR 53(54%), Complete remission 20(20%)
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Out of the 96 patients, the median age was 50 years (range 23-71 years. Forty-five (46%) patients had elevated dNLR.With a median follow-up of 19.4 months, the median Progression-free survival (PFS)and overall survival(OS) was 16.3 months and not reached respectively. 2-year estimated PFS and OS was38% and 75% respectively. Baseline high dNLR was associated with significantly low objective response rate (ORR)(p = 0.003), inferior PFS (HR 3.5, 95%CI 2.01-6.07, p-value

Conclusions

In patients with metastatic breast cancer, inflammatory biomarker like elevated dNLR is strongly associated with low objective response rate, poor progression-free and overall survival. In view of easy reproducibility, it can be incorporated in management decisions as a prognostic factor across subgroups.

Clinical trial indentification

None

Legal entity responsible for the study

All India Institute of Medical Science, New Delhi

Funding

All India Institute of Medical Science, New Delhi

Disclosure

All authors have declared no conflicts of interest.