Assessing Pathological Complete Response in Locally Advanced Breast Cancer: The Role of Inflammatory and Nutritional Biomarkers

The Role of Inflammatory and Nutritional BiomarkersAim: Neoadjuvant chemotherapy (NAC) aims to achieve pathological complete response (pCR), which is linked to improved outcomes in locally advanced breast cancer (LABC).Identifying reliable predictors of pCR remains a clinical priority.Methods: This retrospective study included 44 women, with a median age of 50 years, with stage 2B-3C breast cancer who underwent NAC followed by surgery.Inflammatory markers [systemic inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), erythrocyte-to-lymphocyte ratio (ELR), lymphocyte-to-C (LCR)] and nutritional indices [glucose-to-albumin ratio (GAR), hemoglobinto-albumin ratio (HAR), prognostic nutritional index (PNI)] were analyzed.Receiver operating characteristic analysis determined optimal cut-off values, and binary logistic regression evaluated independent predictors of pCR. Results:The overall pCR rate was 38.6%.Among histological subtypes, luminal B tumors were more frequent in both groups, with 40.7% in the non-pCR group and 29.4% in the pCR group.Triple-positive and HER2-positive tumors were more common in the pCR group.GAR 2.04 emerged as the only independent predictor of pCR (odds ratio=0.09,95% confidence interval: 0.01-0.70,p=0.02).ELR >2.69 and LCR >0.64 showed significant associations with pCR (p=0.03 and p=0.04, respectively), though they lacked independent predictive value.SII, NLR, PLR, HAR, and PNI demonstrated no significant correlation with pCR. Conclusion:This study assessed significant cut-off values, ELR >2.69 and LCR >0.64, that might predict the pCR in LABC.GAR, with a cut-off value of 2.04, was found to be an independent predictive marker for pCR.