343P - Does baseline absolute neutrophil-to-lymphocyte ratio (NLR) correlate with pathological complete response (pCR) in neoadjuvant breast cancer (BC)?

Date 27 September 2014
Event ESMO 2014
Session Poster Display session
Topics Anticancer Agents
Pathology/Molecular Biology
Translational Research
Breast Cancer
Basic Scientific Principles
Basic Principles in the Management and Treatment (of cancer)
Biological Therapy
Presenter Niamh Coleman
Citation Annals of Oncology (2014) 25 (suppl_4): iv110-iv115. 10.1093/annonc/mdu328
Authors N. Coleman1, F. Mohamad Rom2, A. Brennan2, K. Bennett2, A.K. Jayaram3, M..J. Kennedy4
  • 1Medical Oncology, St. James's Hospital, D 8 - Dublin /IE
  • 2Medical Oncology, St. James's Hospital, D 8 - Dublin/IE
  • 3Department Of Medical Oncology, St James's Hospital, 8 - Dublin/IE
  • 4Medical Oncology, St James's Hospital, IE-8 - Dublin/IE



The baseline NLR is a laboratory marker used to evaluate systemic inflammation. This has been suggested as a potential prognostic marker in many solid tumors, including breast cancer. In neoadjuvant BC studies, pCR is used as a surrogate marker for disease free-survival (DFS) and overall survival (OS). We aimed to investigate the prognostic impact of baseline NLR in BC with respect to pCR, relapse-free survival (RFS) and progression free survival (PFS) in pts undergoing neoadjuvant chemotherapy.


Data were collected from a prospectively maintained database for all patients (pts) treated with neoadjuvant chemotherapy for BC, followed by definitive surgical resection from December 2008 to March 2014. Clinical pathological factors were examined using univariate and multivariate analysis with relation to NLR. Chi-square test and wilcoxon rank sum test were used.


114 female pts were identified. pCR was demonstrated in 10.52% (n = 12). During follow-up, 18.4% of pts (n = 21) relapsed while 1pt died without relapse. The median time to relapse or death was 17 months (mnths) (6-48 mnths) and PFS was 28.3 mnths ( 7.5-66.7 mnths). Univariate and multivariate analyses for 9 variables are described in the table. Only 2 parameters remained statistically significant on multivariate analyses - PR and Her2 status. NO significant association was noted between the low and high NLR for pCR (p = 0.56).

Univariate Multivariate
HR P value HR P value
HER 2 status (-ve vs +) 3.44 0.099 6.96 (95%CI 1.46, 33.3) 0.015
PR status (-ve vs +ve) 10.14 0.002 25.1 (95%CI 3.07, 204.5) 0.003
ER status (-ve vs +vs) 3.09 0.023 1.57(95%CI 0.56, 4.41) 0.39
LVI (any vs none) 2.20 0.067 1.57 (95%CI 0.55, 4.48) 0.40
RT stage T1&T2 T3 T4 TX 1.0 1.41 1.40 4.95 0.046 1.0 0.81 (95%CI 0.19, 3.38) 1.58 (95%CI 0.43, 5.78) 1.62 (95%CI 0.39,6.6) 0.71
pCR (any vs 00) 3.47 0.23
NL Ratio 1.35 0.054 1.11 (95%CI 0.75, 1.65) 0.71
Ratio PLT/Lymp 0.80 0.51
NL ratio (High vs Low; median cut-off, 2.464) 1.67 0.25


In contrast to recent data, our results suggest that baseline NLR does not correlate with pCR or act as an independent prognostic factor in neoadjuvant BC. PR status and Her-2 status were confirmed as important markers for relapse.


All authors have declared no conflicts of interest.