Inflammatory Blood Markers as Prognostic and Predictive Factors in Early Breast Cancer Patients Receiving Neoadjuvant Chemotherapy

Simple Summary Predictive and prognostic factors are necessary to evaluate the future of women with early breast cancer. Inflammatory blood markers such as neutrophil to lymphocytes ratio and platelet to lymphocytes ratio have been reported to be a predictive factor for pathological complete response and a prognostic factor in breast cancer, with conflicting results. Here we evaluate these inflammatory blood markers in patients with early breast cancer receiving neo adjuvant chemotherapy since neo adjuvant treatment is more and more developed in early breast cancer. Background: Inflammatory blood markers, such as neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR), have been reported as putative prognostic factors for survival and predictive factors for pathological complete response and toxicity in cancers, however with conflicting results. Methods: We retrospectively analyzed data of 280 patients with early breast cancer receiving neo-adjuvant chemotherapy between 2005 and 2013 in our center. Neutrophil count, lymphocyte count and platelet count before treatment were collected as well as data on pathological complete response, toxicity, recurrence and survival. Results: In multivariate analysis, high PLR was an independent prognostic factor for relapse-free survival (hazard ratio [HR] = 1.91; 95%CI = 1.15-3.16;p= 0.012) and for shorter overall survival (HR = 1.83; 95%CI = 1.03-3.24;p= 0.039). NLR was an independent predictive factor for febrile neutropenia (HR = 0.28; 95%CI = 0.13-0.58;p= 0.001). In triple negative breast cancer molecular subtype, low white blood cell count (<6.75 G/L) was predictive for a higher pathological complete response rate (odds ratio [OR] = 0.29; 95%CI = 0.14-0.61;p< 0.01). Conclusion: In the present study, PLR was found as an independent prognostic factor for survival, while NLR was an independent predictive factor for febrile neutropenia.