The prognostic and predictive role of the neutrophil-to-lymphocyte ratio and the monocyte-to-lymphocyte ratio in early b
- PDF / 752,970 Bytes
- 10 Pages / 595.276 x 790.866 pts Page_size
- 71 Downloads / 151 Views
PRECLINICAL STUDY
The prognostic and predictive role of the neutrophil‑to‑lymphocyte ratio and the monocyte‑to‑lymphocyte ratio in early breast cancer, especially in the HER2+ subtype Satu Tiainen1,2 · Kirsi Rilla3 · Kirsi Hämäläinen4,5,6 · Sanna Oikari3 · Päivi Auvinen1,2 Received: 23 May 2020 / Accepted: 2 September 2020 © The Author(s) 2020
Abstract Purpose The aim of this study was to investigate the prognostic impact of two systemic inflammatory markers, the neutrophilto-lymphocyte ratio (NLR) and the monocyte-to-lymphocyte ratio (MLR), and their possible predictive role regarding the efficacy of adjuvant trastuzumab, in 209 early breast cancer cases, 107 of which were HER2-positive. Methods Baseline NLR and MLR values were divided into two groups, high and low, according to cut-off-points determined from the ROC curve (2.2 for NLR and 0.22 for MLR). Cox’s model was utilized for survival analyses. Results High NLR and MLR correlated with poor overall survival (OS) and breast cancer specific survival (BCSS) among all the patients (p ≤ 0.030). Among the HER2+ patients whose adjuvant treatment did not include trastuzumab (n = 64), the survival rates were remarkably lower in patients with a high NLR as compared to those with low; 31% vs. 71% for OS and 42% vs. 74% for BCSS (p ≤ 0.014). Similarly, high MLR correlated with poor survival among these patients (p ≤ 0.020). On the contrary, among the patients who had received adjuvant trastuzumab (n = 43), NLR or MLR did not correlate with survival. Furthermore, trastuzumab was beneficial for the HER2+ patients with high NLR/MLR, while the survival of the HER2+ patients with low NLR/MLR was good irrespective if they received adjuvant trastuzumab. Conclusions Our results suggest that trastuzumab modulates the systemic inflammatory conditions and overcomes the poor prognostic impact of high NLR/MLR. This finding may also provide a rationale for combining trastuzumab with immunooncological treatments in HER2+ breast cancer. Keywords Breast cancer · NLR · MLR · Trastuzumab · HER2
Introduction Systemic inflammatory state of the host and the inflammatory response in the tumor microenvironment have a remarkable impact on cancer progression [1, 2]. Neutrophils Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10549-020-05925-7) contains supplementary material, which is available to authorized users. * Satu Tiainen [email protected] 1
Cancer Center, Kuopio University Hospital, P.O. Box 100, 70029 Kuopio, Finland
2
Institute of Clinical Medicine, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland
3
Institute of Biomedicine, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland
secrete cytokines that promote cancer growth [3], and they may also suppress the immune responses mediated by lymphocytes [4]. Furthermore, monocytes are able to suppress lymphocyte activation and enhance tumor progression [5]. On the other hand, lymphocytes have an important role in the immune respons
Data Loading...
