Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Prognostic Relevance of Neutrophil to Lymphocyte Ratio (NLR) in Luminal Breast Cancer: A Retrospective Analysis in the Neoadjuvant Setting

Version 1 : Received: 7 May 2021 / Approved: 7 May 2021 / Online: 7 May 2021 (12:26:14 CEST)

A peer-reviewed article of this Preprint also exists.

Grassadonia, A.; Graziano, V.; Iezzi, L.; Vici, P.; Barba, M.; Pizzuti, L.; Cicero, G.; Krasniqi, E.; Mazzotta, M.; Marinelli, D.; Amodio, A.; Natoli, C.; Tinari, N. Prognostic Relevance of Neutrophil to Lymphocyte Ratio (NLR) in Luminal Breast Cancer: A Retrospective Analysis in the Neoadjuvant Setting. Cells 2021, 10, 1685. Grassadonia, A.; Graziano, V.; Iezzi, L.; Vici, P.; Barba, M.; Pizzuti, L.; Cicero, G.; Krasniqi, E.; Mazzotta, M.; Marinelli, D.; Amodio, A.; Natoli, C.; Tinari, N. Prognostic Relevance of Neutrophil to Lymphocyte Ratio (NLR) in Luminal Breast Cancer: A Retrospective Analysis in the Neoadjuvant Setting. Cells 2021, 10, 1685.

Journal reference: Cells 2021, 10, 1685
DOI: 10.3390/cells10071685

Abstract

Neutrophil to lymphocyte ratio (NLR) is a promising predictive and prognostic factor in breast cancer. We investigated its ability to predict disease-free survival (DFS) and overall survival (OS) in patients with luminal A or luminal B-HER2-negative breast cancer who received neoadjuvant chemotherapy (NACT). Pre-treatment complete blood cell counts from 168 consecutive patients with luminal breast cancer were evaluated to assess NLR. The study population was stratified into NLRlow or NLRhigh according to a cut-off value established by receiving operator curve (ROC) analysis. Data on additional pre- and post-treatment clinical-pathological characteristics were also collected. Kaplan-Meier curves, log-rank tests, and Cox proportional hazards models were used for statistical analyses. Patients with pre-treatment NLRlow showed a significantly shorter DFS (HR 6.97, 95% CI 1.65-10.55, p= 0.002) and OS (HR 7.79, 95% CI 1.25-15.07, p= 0.021) compared to those with NLRhigh. Non-ductal histology, luminal B subtype, and post-treatment Ki67≥ 14% were also associated with worse DFS (p= 0.016, p= 0.002, and p= 0.001, respectively). In multivariate analysis, luminal B subtype, post-treatment Ki67≥ 14%, and NLRlow remained independent prognostic factors for DFS, while only post-treatment Ki67≥ 14% and NLRlow affected OS. The present study provides evidence that pre-treatment NLRlow helps identify women at higher risk of recurrence and death among patients affected by luminal breast cancer treated with NACT.

Keywords

luminal breast cancer; neoadjuvant therapy; neutrophil to lymphocyte ratio (NLR); platelet to lymphocyte ratio (PLR); predictive/prognostic biomarkers

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