Abstract
ntroduction/Background
Some reports have shown that absolute lymphocyte count (ALC) is associated with prognosis
in breast cancer; however, the impact of ALC changes remains unclear. This study aimed
to investigate the relationship between ALC changes during neoadjuvant chemotherapy
for human epidermal growth factor receptor-2 (HER2)-positive breast cancer patients
and disease prognosis.
Patients and Methods
This retrospective cohort study January 2010 to September 2020) included patients
diagnosed with HER2-positive breast cancer and treated with trastuzumab-based neoadjuvant
chemotherapy. The ALC ratio was defined as the ALC value after administration of the
anti-HER2 drug divided by the ALC value before administration. The optimal ALC ratio
cut-off value was identified using the receiver operating characteristic curve analysis
and Youden's index. The relationship between the ALC ratio and disease-free survival
was assessed using the Kaplan–Meier method. Univariate and multivariate analyses were
performed using the Cox proportional hazards model.
Results
Data from a total of 100 HER2-positive breast cancer patients were analyzed. The cut-off
value of the ALC ratio was set as 1.142. The median follow-up period was 52.0 (range:
5.1-123.7) months. The 5-year disease-free survival rates were 88.4% and 60.9% in
the high-and low-ALC ratio groups, respectively, and were significantly higher in
the high-ALC ratio group (p = .0031). The ALC ratio was an independent prognostic factor in multivariate Cox
proportional hazards analysis (p = .0032).
Conclusion
HER2-positive breast cancer patients with a higher ALC ratio during trastuzumab-based
neoadjuvant chemotherapy may have a better prognosis than their counterparts.
Keywords
Abbreviations:
NAC (neoadjuvant chemotherapy), HER-2 (human epidermal growth factor receptor-2), TNBC (triple-negative breast cancer), pCR (pathological complete response), NLR (neutrophil-to-lymphocyte ratio), PLR (platelet-to-lymphocyte ratio), ALC (absolute lymphocyte count), ADCC (antibody-dependent cell-mediated cytotoxicity), NK (natural killer cells), DFS (disease-free survival), HR (hazard ratio), CI (confidence interval), TIL (tumor-infiltrating lymphocytes)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: January 11, 2023
Accepted:
January 8,
2023
Received in revised form:
January 6,
2023
Received:
May 3,
2022
Identification
Copyright
© 2023 Elsevier Inc. All rights reserved.
