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
397P - Development of prediction model for hepatocellular carcinoma in chronic hepatitis B patients
Presenter: Teerapat Ungtrakul
Session: Poster display session
Resources:
Abstract
398P - Planning for future cancer control programs in Uganda: Projections of top five cancers’ incidence in the next decade
Presenter: Judith Asasira
Session: Poster display session
Resources:
Abstract
399P - Prevalence of colorectal cancer risk factors in apparently healthy adults in Suluhan Village, Bali
Presenter: Cindy Trisina
Session: Poster display session
Resources:
Abstract
400P - Female lung cancer: Emerging issue in Bangladesh
Presenter: Muhammad Rafiqul Islam
Session: Poster display session
Resources:
Abstract
402P - Work-related outcomes among cancer survivors in Singapore
Presenter: Chia Jie Tan
Session: Poster display session
Resources:
Abstract
407P - Focal treatments for metastatic soft tissue sarcoma (mSTS) is associated with improved overall survival
Presenter: Ching Tso Chen
Session: Poster display session
Resources:
Abstract
408P - The Asian sarcoma consortium sarcoma preceptorship program: A program evaluation study utilizing the Kirkpatrick model (Level 1 and 2)
Presenter: Fernando Gracieux Jr.
Session: Poster display session
Resources:
Abstract
409P - Integrated genomic and transcriptomic analysis revealed mutagenic patterns of dedifferentiated liposarcoma and leiomyosarcoma in Chinese patients
Presenter: Yuhong Zhou
Session: Poster display session
Resources:
Abstract
410P - Treatment patterns and outcomes of elderly patients with metastatic soft tissue sarcomas (mSTS)
Presenter: Yu-ju Kuo
Session: Poster display session
Resources:
Abstract
411P - Comparative analysis of protein profiles of prognosis-associated proteins and KIT-related proteins in gastrointestinal stromal tumour
Presenter: Yoshiyuki Suehara
Session: Poster display session
Resources:
Abstract