Abstract 260P
Background
Inflammatory Breast Cancer (IBC) is a rare and aggressive disease, associated with poor outcomes owing to the absence of prognostic factors and therapeutic targets specific to IBC.Cancer-related inflammation plays a critical role in cancer development and progression. The Neutrophil-Lymphocyte Ratio (NLR), which has a comprehensive evaluation of the balance between systemic inflammation and immunity plays a role in prognostic prediction of cancers. The goal of this study was to assess the prognostic and predictive values of NLR in patients with non metastatic IBC.
Methods
A retrospective analysis of 102 non metastatic IBC patients who were treated at Medical Oncology department, University Hospital Mohammed VI-Oujda, Morocco, between January 2010 and December 2014 was performed. NLR was obtained from differential white blood cell count, at diagnosis, before starting any neoadjuvant chemotherapy (NAC). Peripheral blood NLR of 2.28 at baseline was used as cut off to divide patients into two groups. The correlation between NLR groups and response to NAC was analyzed by binary logistic regression model. The prognostic value [overall survival (OS) and disease-free-survival (DFS) at 5 years] of the pre-treatment NLR was assessed by Kaplan-Meier curves and Cox regression models.
Results
Data analysis focused in 102 patients, 70 and 32 patients were grouped as low and high NLR, respectively, on the basis of NLR value of 2.28. 8 (7.8%) achieved a pathological complete response (pCR). In multivariate analysis, a low NLR remained the only predictive factor of pCR (OR: 4.05; p = 0.027). The low ratio group demonstrated a better DFS (p<0.001) and longer OS (p<0.001) in univariate survival analysis than the high-ratio group. The multivariate Cox proportional hazards models confirmed high NLR values as independent prognostic variable of worse outcome, associated with shorter DRS (HR = 2.57, 95% CI = 1.43–4.61, p = 0.001) and OS (HR = 2.92, 95% CI = 1.7–5.02, p<0.001).
Conclusions
This is the first study, to our knowledge, to show a significant correlation between high NLR and worse NAC response and prognosis in non metastatic IBC. Further prospective studies are needed to confirm our findings and to justify introducing NLR assessment in clinical practice for IBC.
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.