Abstract 27P
Background
There is growing evidence that elevated neutrophil to lymphocyte ratio (NLR) is associated with poor treatment response and survival outcomes in breast cancer. Also, standardized uptake value (SUV) of 18F-fluorodeoxyglucose (FDG) PET has been applied as a prognostic factor in breast cancer. In this study, we investigated the treatment response and survival outcomes according to NLR and SUV in breast cancer patients who received neoadjuvant chemotherapy (NAC).
Methods
Baseline NLR and SUVmax of 18F-FDG PET was retrospectively analyzed in 273 breast cancer patients who were received NAC followed by surgery from January 2007 to June 2018. Baseline NLR is calculated as absolute neutrophil count divided by absolute lymphocyte count from blood samples taken before initiation of NAC. Of the total, 101 patients underwent 18F-FDG PET after 3-4 cycles of NAC. The ΔSUVmax, the percentage reduction between SUVmax at baseline and after 3-4 cycles of NAC, was obtained from these patients. NLR and ΔSUVmax was classified as high and low relative to the median values (NLR: 2.04 and ΔSUVmax: 73.3%).
Results
The patients with pathologic complete response (pCR) had lower NLR and higher ΔSUVmax. Among all patients, high NLR was associated poor survival outcomes in terms of disease-free survival (DFS, adjusted HR 2.42; 95% Cis, 1.23-4.78; P = 0.011) and overall survival (OS, adjusted HR 1.53; 95% Cis, 1.19-1.97; P = 0.001), respectively. In 101 patients with data for early change of SUVmax, the high NLR (adjusted HR 3.20; 95% CIs, 1.29-7.89; P = 0.015) and low ΔSUVmax (adjusted HR 3.20; 95% CIs, 1.29-7.89; P = 0.015) were an independent prognostic factor for poor RFS. When patients were categorized into four groups according to NLR and ΔSUVmax, the patients with high NLR and low ΔSUVmax had significantly poor RFS (adjusted HR 8.71; 95% CIs, 1.87-40.64; P = 0.006) compared to those with low NLR and high ΔSUVmax.
Conclusions
Both the baseline NLR and ΔSUVmax were associated with treatment response and prognosis in breast cancer patients who received NAC. Moreover, we identified that metabolic non-responders with degraded immune system had a worst impact on survival outcomes.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
329P - High-level expression of HDAC10 is associated with PD-L1 expression and poor prognosis in patients with non-small cell lung cancer receiving pulmonectomy
Presenter: Xiaomei Liu
Session: Poster display session
Resources:
Abstract
331P - A retrospective analysis of immune checkpoint therapy in patients with non-small cell lung cancer: Focus on thyroid disorder
Presenter: Sawana Ono
Session: Poster display session
Resources:
Abstract
332P - Analyse the association between adverse events (AEs) and survival in patients treated with immune checkpoint inhibitors (ICIs)
Presenter: Chi-yuan Cheng
Session: Poster display session
Resources:
Abstract
333P - Study of searching on efficacy of immune checkpoint inhibitor for the non-small cell lung cancer using FDG-PET/CT and thallium SPECT
Presenter: KAYOKO Kibata
Session: Poster display session
Resources:
Abstract
334P - Incidence and characteristic of adrenal insufficiency due to immune checkpoint inhibitors therapy
Presenter: Daisuke Etoh
Session: Poster display session
Resources:
Abstract
335P - PD-L1 profile of nasopharyngeal cancer patients in Indonesia
Presenter: Handoko Handoko
Session: Poster display session
Resources:
Abstract
336P - Pembrolizumab plus chemotherapy versus pembrolizumab monotherapy for PD-L1-positive advanced non-small cell lung cancer in the real world
Presenter: Jun Sugisaka
Session: Poster display session
Resources:
Abstract
337P - Neutrophil-to-Lymphocyte ratio as a predictive factor for hyperprogressive disease in NSCLC patients treated with immune checkpoint inhibitor
Presenter: Ryo Takahashi
Session: Poster display session
Resources:
Abstract
338P - A new insight into tumour immune-evasion: Crosstalk between cancer stem cells and T regulatory cells
Presenter: Abhishek Dutta
Session: Poster display session
Resources:
Abstract
339TiP - PACIFIC-5: Phase III study of durvalumab after either concurrent or sequential chemoradiotherapy (CRT) in patients with stage III NSCLC
Presenter: Yi-Long Wu
Session: Poster display session
Resources:
Abstract