Abstract 172P
Background
Inflammatory biomarkers such as neutrophil-to-lymphocyte ratio (NLR) prognostic predictors in patients (pts) with breast cancer (BC). However, the relationship between NLR prognostic capacity and the different stages of early TNBC remains unexplored. We aim to assess the prognostic value of NLR in TNBC pts treated with neoadjuvant chemotherapy (NACT) according to clinical stages (CS).
Methods
We performed a retrospective analysis of TNBC pts treated with anthracycline and taxane-based NACT and surgery in our institution. Electronic records were reviewed for clinical characteristics and outcomes. NLR was assessed before NACT. Survival was estimated by Kaplan-Meier and log-rank test. Prognostic factors were evaluated by Cox regression.
Results
From 2011 to 2018, 1.900 BC pts were treated with NACT, of which 441 with TNBC. Median follow-up was 4.51 years. Median age was 49.3 years (22 - 80), 69.4% had high histologic grade, 71% had T3-T4 disease, 69.4% had clinical nodal involvement and 37.9% and 61.9% of pts were classified as CS II and III, respectively. Following NACT, pts underwent surgery (58.5% mastectomy and 54.6% axillary lymph node dissection) and 91.2% radiotherapy. Factors included in the univariate analysis were age, grade, clinical and pathologic (path) T and N stages, body mass index and baseline NLR. Among pts with stage II disease, age, path stage T and N, and NLR were associated with risk of relapse in the univariate analysis, while path stage T (HR 2.12, 95% CI 1.37 - 3.27, p = 0.001), and NLR (HR 1.32, 95 % CI 1.10 - 1.58, p = 0.002) remained independent predictors in the multivariate analysis. Among pts with stage III disease, age (HR 0.98, 95% CI 0.96 - 1.0, p = 0.047), path stage T (HR 1.59, 95% CI 1.31 - 1.92, p <0.001), and path stage N (HR 1.81 , 95% CI 1.44 - 2.26, p <0.001) were independently associated with risk of relapse, but NLR had no significant predictive value in this stage group (HR 1.01, 95% CI 0.97 - 1.10, p = 0.955). Differences between DFS curves according to NLR (using a cut-off of 2.0) were significant for pts with stage II (log-rank p = 0.032), but not for pts with stage III (log-rank p = 0.143).
Conclusions
The prognostic information provided by NLR in TNBC pts appears to vary dynamically with the clinical stage.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
G. Nader Marta: Financial Interests, Personal, Other, Financial aid to attend international meetings.: Roche; Financial Interests, Personal, Other, Financial aid to attend international meetings.: Bayer. M.F. Batistuzzo Vicentini: Financial Interests, Personal, Full or part-time Employment: BMS Brazil. L. Testa: Financial Interests, Personal, Speaker’s Bureau: Lilly, Novartis, Pfizer, Roche, Libbs; Financial Interests, Personal, Advisory Board: MSD, Lilly, Novartis, Genomic Health; Financial Interests, Personal, Other, Travel for meeting: Pfizer, Roche, Libbs, United Medical. All other authors have declared no conflicts of interest.