Peripheral Inflammation/Immune Biomarkers Of Chemosensitivity And Prognosis In Breast Cancer Patients Treated With Neoadjuvant Chemotherapy

Introduction: Neoadjuvant chemotherapy(NAC)has become a standard treatment for locally advanced breast cancer.Patients with pathological complete response(p CR)to NAC are considered to have a longer disease-free survival(DFS)than those without p CR.Effective indictors are required to predict the response to appropriate chemotherapy regimens.With the introduction of tumor microenvironment,there has been a worldwide upsurge of research interest in tumor-associated immune cells in recent years.The present study was designed to investigate the predictive value of different peripheral inflammation/immune biomarkers on response to NAC and prognosis in breast cancer patients.Materials and methods: 180 breast cancer patients treated with NAC in the First Affiliated Hospital with Nanjing Medical University between January 2008 and March 2015 were enrolled in the study.The associations between inflammation/immune biomarkers and pathological complete response(p CR)were determined,and the prognostic value of inflammation/immune indicators were also evaluated.Results: In the univariate analysis,patients with a high pretreatment peripheral lymphocyte-count(> 2.06*10^9/L)showed a higher p CR rate than those with a low lymphocyte-count(23.9% vs.10.4%,P = 0.023).The pCR rate of patients with a neutrophil-lymphocyte ratio(NLR)? 2.10 was significantly higher than that of patients with a high NLR(20.5% vs 7.6%;P = 0.017).However,multivariate analysis revealed that only the high lymphocyte-count was predictive for p CR(Odds Ratio: 4.375,95% CI: 1.429-13.392,P = 0.010).In the survival analysis,patients with a higher neutrophil-count(> 2.65*10^9/L)were confirmed to have a shorter disease-free survival(Hazard Ratio: 2.727,95% CI: 1.162–6.398,P=0.021)and the high neutrophil-count was significantly associated with lymphovascular invasion(P = 0.039).Conclusion: We demonstrated that a high level of baseline peripheral lymphocyte-count can be a predictor for high efficacy of NAC for breast cancer patients,and low baseline peripheral neutrophil-count may contribute to the favorable disease-free survival.