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Mousset A, Bellone L, Gaggioli C, Albrengues J. NETscape or NEThance: tailoring anti-cancer therapy. Trends Cancer 2024; 10:655-667. [PMID: 38664080 DOI: 10.1016/j.trecan.2024.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 03/14/2024] [Accepted: 03/15/2024] [Indexed: 07/12/2024]
Abstract
Neutrophils, major regulators of innate immunity, have recently emerged as key components of the tumor microenvironment. The role of neutrophils in cancer has been linked to their ability to form neutrophil extracellular traps (NETs), structures composed of decondensed DNA decorated with enzymes that are released into the extracellular space. Here, we discuss the pivotal roles of NETs in influencing responses to anticancer therapies such as chemotherapy, radiotherapy, immunotherapy, and targeted therapy. Highlighting recent insights, we delve into the dual nature of NETs in the context of anticancer treatments, examining their potential to either counteract or enhance treatment outcomes. Strategic targeting of NETs may be a promising avenue for crafting combination therapies to counteract resistance or enhance anticancer treatments' efficacy.
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Affiliation(s)
- Alexandra Mousset
- University Côte d'Azur, CNRS UMR7284, INSERM U1081, Institute for Research on Cancer and Aging, Nice (IRCAN), Nice, France
| | - Lola Bellone
- University Côte d'Azur, CNRS UMR7284, INSERM U1081, Institute for Research on Cancer and Aging, Nice (IRCAN), Nice, France
| | - Cedric Gaggioli
- University Côte d'Azur, CNRS UMR7284, INSERM U1081, Institute for Research on Cancer and Aging, Nice (IRCAN), Nice, France
| | - Jean Albrengues
- University Côte d'Azur, CNRS UMR7284, INSERM U1081, Institute for Research on Cancer and Aging, Nice (IRCAN), Nice, France.
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2
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Mousset A, Albrengues J. Neutrophil extracellular traps modulate chemotherapy efficacy and its adverse side effects. Biol Cell 2024; 116:e2400031. [PMID: 38724262 DOI: 10.1111/boc.202400031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 04/10/2024] [Accepted: 04/17/2024] [Indexed: 07/13/2024]
Abstract
Neutrophils, major regulator of innate immunity have recently emerged as key components of the tumor microenvironment. The role of neutrophils in cancer has been linked to their ability to form neutrophil extracellular traps (NETs), structures composed of decondensed DNA decorated with enzymes that are released into the extracellular space. Here, we discuss the pivotal roles of NETs, in influencing responses to chemotherapy and its severe adverse effect. Highlighting recent insights, we discuss the dual nature of NETs in the context of chemotherapy treatment, examining their potential to either counteract or enhance treatment outcomes. Strategic targeting of NETs emerges as a promising avenue for determining combination therapies that could help counteracting resistance or enhancing chemotherapy efficacy as well as limiting complications due to this type of treatment.
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Affiliation(s)
- Alexandra Mousset
- Institute for Research on Cancer and Aging, University Côte d'Azur, Nice, France
| | - Jean Albrengues
- Institute for Research on Cancer and Aging, University Côte d'Azur, Nice, France
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3
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Mousset A, Lecorgne E, Bourget I, Lopez P, Jenovai K, Cherfils-Vicini J, Dominici C, Rios G, Girard-Riboulleau C, Liu B, Spector DL, Ehmsen S, Renault S, Hego C, Mechta-Grigoriou F, Bidard FC, Terp MG, Egeblad M, Gaggioli C, Albrengues J. Neutrophil extracellular traps formed during chemotherapy confer treatment resistance via TGF-β activation. Cancer Cell 2023; 41:757-775.e10. [PMID: 37037615 PMCID: PMC10228050 DOI: 10.1016/j.ccell.2023.03.008] [Citation(s) in RCA: 49] [Impact Index Per Article: 49.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 12/13/2022] [Accepted: 03/07/2023] [Indexed: 04/12/2023]
Abstract
Metastasis is the major cause of cancer death, and the development of therapy resistance is common. The tumor microenvironment can confer chemotherapy resistance (chemoresistance), but little is known about how specific host cells influence therapy outcome. We show that chemotherapy induces neutrophil recruitment and neutrophil extracellular trap (NET) formation, which reduces therapy response in mouse models of breast cancer lung metastasis. We reveal that chemotherapy-treated cancer cells secrete IL-1β, which in turn triggers NET formation. Two NET-associated proteins are required to induce chemoresistance: integrin-αvβ1, which traps latent TGF-β, and matrix metalloproteinase 9, which cleaves and activates the trapped latent TGF-β. TGF-β activation causes cancer cells to undergo epithelial-to-mesenchymal transition and correlates with chemoresistance. Our work demonstrates that NETs regulate the activities of neighboring cells by trapping and activating cytokines and suggests that chemoresistance in the metastatic setting can be reduced or prevented by targeting the IL-1β-NET-TGF-β axis.
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Affiliation(s)
- Alexandra Mousset
- University Côte d'Azur, CNRS UMR7284, INSERM U1081, Institute for Research on Cancer and Aging, Nice (IRCAN), Nice, France
| | - Enora Lecorgne
- University Côte d'Azur, CNRS UMR7284, INSERM U1081, Institute for Research on Cancer and Aging, Nice (IRCAN), Nice, France; University Côte d'Azur, CNRS UMR7284, INSERM U1081, Institute for Research on Cancer and Aging, Nice (IRCAN), 3D-Hub-S Facility, Nice, France
| | - Isabelle Bourget
- University Côte d'Azur, CNRS UMR7284, INSERM U1081, Institute for Research on Cancer and Aging, Nice (IRCAN), Nice, France; University Côte d'Azur, CNRS UMR7284, INSERM U1081, Institute for Research on Cancer and Aging, Nice (IRCAN), 3D-Hub-S Facility, Nice, France
| | - Pascal Lopez
- University Côte d'Azur, CNRS UMR7284, INSERM U1081, Institute for Research on Cancer and Aging, Nice (IRCAN), Nice, France
| | - Kitti Jenovai
- University Côte d'Azur, CNRS UMR7284, INSERM U1081, Institute for Research on Cancer and Aging, Nice (IRCAN), Nice, France
| | - Julien Cherfils-Vicini
- University Côte d'Azur, CNRS UMR7284, INSERM U1081, Institute for Research on Cancer and Aging, Nice (IRCAN), Nice, France
| | - Chloé Dominici
- University Côte d'Azur, CNRS UMR7284, INSERM U1081, Institute for Research on Cancer and Aging, Nice (IRCAN), Nice, France
| | - Géraldine Rios
- University Côte d'Azur, CNRS UMR7275, Institute of Molecular and Cellular Pharmacology (IPMC), Sophia Antipolis, France
| | - Cédric Girard-Riboulleau
- University Côte d'Azur, CNRS UMR7275, Institute of Molecular and Cellular Pharmacology (IPMC), Sophia Antipolis, France
| | - Bodu Liu
- Cold Spring Harbor Laboratory, Cold Spring Harbor, NY 11724, USA
| | - David L Spector
- Cold Spring Harbor Laboratory, Cold Spring Harbor, NY 11724, USA
| | - Sidse Ehmsen
- Department of Oncology, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Shufang Renault
- Circulating Tumor Biomarkers Laboratory, INSERM CIC-BT 1428, Department of Translational Research, Institut Curie, Paris, France
| | - Caroline Hego
- Circulating Tumor Biomarkers Laboratory, INSERM CIC-BT 1428, Department of Translational Research, Institut Curie, Paris, France
| | - Fatima Mechta-Grigoriou
- Stress and Cancer Laboratory, Institut Curie, INSERM, U830, PSL Research University, Ligue Nationale Contre le Cancer labeled Team, 26, Rue d'Ulm, 75005, Paris, France
| | - François-Clément Bidard
- Circulating Tumor Biomarkers Laboratory, INSERM CIC-BT 1428, Department of Translational Research, Institut Curie, Paris, France; Department of Medical Oncology, Institut Curie, Saint Cloud, Paris, France; University of Versailles Saint-Quentin-en-Yvelines (UVSQ), Paris-Saclay University, Saint Cloud, France
| | - Mikkel Green Terp
- Department of Cancer and Inflammation Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Mikala Egeblad
- Cold Spring Harbor Laboratory, Cold Spring Harbor, NY 11724, USA
| | - Cédric Gaggioli
- University Côte d'Azur, CNRS UMR7284, INSERM U1081, Institute for Research on Cancer and Aging, Nice (IRCAN), Nice, France; University Côte d'Azur, CNRS UMR7284, INSERM U1081, Institute for Research on Cancer and Aging, Nice (IRCAN), 3D-Hub-S Facility, Nice, France.
| | - Jean Albrengues
- University Côte d'Azur, CNRS UMR7284, INSERM U1081, Institute for Research on Cancer and Aging, Nice (IRCAN), Nice, France.
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Li N, Cao L, Zhao K, Feng Y. Development and validation of a nomogram to predict Chinese breast cancer risk based on clinical serum biomarkers. Biomark Med 2023; 17:273-286. [PMID: 37284737 DOI: 10.2217/bmm-2022-0933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023] Open
Abstract
Background: This study investigated and compared clinical serum biomarkers and developed a diagnostic nomogram for breast cancer. Methods: A total of 1224 breast cancer and 1280 healthy controls were enrolled. Univariate and multivariate analyses were performed to identify factors and a nomogram was developed. Discrimination, accuracy and clinical utility values were evaluated by receiver operating characteristic, Hosmer-Lemeshow, calibration plots, decision curve analysis and clinical impact plots. Results: carcinoembryonic antigen, CA125, CA153, lymphocyte-to-monocyte ratio, platelet-to-lymphocyte ratio, fibrinogen and platelet distributing width were effectively identified to predict breast cancer. The nomogram showed the area under the curve of 0.708 and 0.710 in the training and validation set. Calibration plots, Hosmer-Lemeshow, decision curve analysis and clinical impact plots confirmed great accuracy and clinical utility. Conclusion: We developed and validated a nomogram that is effectively used for risk prediction of Chinese breast cancer.
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Affiliation(s)
- Nan Li
- Department of Laboratory Medicine, The First Hospital of China Medical University, Shenyang, Liaoning Province, 110001, China
| | - Lingli Cao
- Department of Laboratory Medicine, The First Hospital of China Medical University, Shenyang, Liaoning Province, 110001, China
- Department of Clinical Medicine, China Medical University, Shenyang, Liaoning Province, 110001, China
| | - Kexin Zhao
- Department of Laboratory Medicine, The First Hospital of China Medical University, Shenyang, Liaoning Province, 110001, China
| | - Yonghui Feng
- Department of Laboratory Medicine, The First Hospital of China Medical University, Shenyang, Liaoning Province, 110001, China
- National Clinical Research Center for Laboratory Medicine, Shenyang, Liaoning Province, 110001, China
- Laboratory Medicine Innovation Unit, Chinese Academy of Medical Sciences, Shenyang, Liaoning Province, 110001, China
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Gianni C, Palleschi M, Merloni F, Bleve S, Casadei C, Sirico M, Di Menna G, Sarti S, Cecconetto L, Mariotti M, De Giorgi U. Potential Impact of Preoperative Circulating Biomarkers on Individual Escalating/de-Escalating Strategies in Early Breast Cancer. Cancers (Basel) 2022; 15:96. [PMID: 36612091 PMCID: PMC9817806 DOI: 10.3390/cancers15010096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/18/2022] [Accepted: 12/20/2022] [Indexed: 12/28/2022] Open
Abstract
The research on non-invasive circulating biomarkers to guide clinical decision is in wide expansion, including the earliest disease settings. Several new intensification/de-intensification strategies are approaching clinical practice, personalizing the treatment for each patient. Moreover, liquid biopsy is revealing its potential with multiple techniques and studies available on circulating biomarkers in the preoperative phase. Inflammatory circulating cells, circulating tumor cells (CTCs), cell-free DNA (cfDNA), circulating tumor DNA (ctDNA), and other biological biomarkers are improving the armamentarium for treatment selection. Defining the escalation and de-escalation of treatments is a mainstay of personalized medicine in early breast cancer. In this review, we delineate the studies investigating the possible application of these non-invasive tools to give a more enlightened approach to escalating/de-escalating strategies in early breast cancer.
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Affiliation(s)
- Caterina Gianni
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy
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Direito I, Gomes D, Monteiro FL, Carneiro I, Lobo J, Henrique R, Jerónimo C, Helguero LA. The Clinicopathological Significance of BiP/GRP-78 in Breast Cancer: A Meta-Analysis of Public Datasets and Immunohistochemical Detection. Curr Oncol 2022; 29:9066-9087. [PMID: 36547124 PMCID: PMC9777260 DOI: 10.3390/curroncol29120710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/15/2022] [Accepted: 11/17/2022] [Indexed: 11/24/2022] Open
Abstract
The endoplasmic reticulum chaperone BiP (also known as GRP-78 or HSPA5) maintains protein folding to allow cell proliferation and survival and has been implicated in carcinogenesis, tumor progression, and therapy resistance. BiP's association with clinical factors and prognostic potential in breast cancer remains unclear. In this work, three types of analysis were conducted to improve the knowledge of BiP's clinicopathological potential: (1) analysis of publicly available RNA-seq and proteomics datasets stratified as high and low quartiles; (2) a systematic review and meta-analysis of immunohistochemical detection of BIP; (3) confirmation of findings by BiP immunohistochemical detection in two luminal-like breast cancer small cohorts of paired samples (pre- vs. post-endocrine therapy, and primary pre- vs. metastasis post-endocrine therapy). The TCGA PanCancer dataset and CPTAC showed groups with high BiP mRNA and protein associated with HER2, basal-like subtypes, and higher immune scores. The meta-analysis of BiP immunohistochemistry disclosed an association between higher BiP positivity and reduced relapse-free survival. BiP immunohistochemistry confirmed increased BiP expression in metastasis, an association of BiP positivity with HER2 expression, and nuclear BiP localization with higher a tumor stage and poor outcome. Therefore, three independent approaches showed that BiP protein is associated with worse outcomes and holds prognostic potential for breast cancer.
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Affiliation(s)
- Inês Direito
- iBiMED—Institute of Biomedicine, University of Aveiro, Agra do Crasto 30, 3810-193 Aveiro, Portugal
| | - Daniela Gomes
- iBiMED—Institute of Biomedicine, University of Aveiro, Agra do Crasto 30, 3810-193 Aveiro, Portugal
| | - Fátima Liliana Monteiro
- iBiMED—Institute of Biomedicine, University of Aveiro, Agra do Crasto 30, 3810-193 Aveiro, Portugal
| | - Isa Carneiro
- Department of Pathology, Portuguese Oncology Institute of Porto (IPO Porto), R. Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal
- Cancer Biology and Epigenetics Group, IPO Porto Research Center (CI-IPOP), Portuguese Oncology Institute of Porto (IPO Porto)/Porto Comprehensive Cancer Centre (Porto.CCC) & RISE@CI-IPOP (Health Research Network), R. Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal
| | - João Lobo
- Department of Pathology, Portuguese Oncology Institute of Porto (IPO Porto), R. Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal
- Cancer Biology and Epigenetics Group, IPO Porto Research Center (CI-IPOP), Portuguese Oncology Institute of Porto (IPO Porto)/Porto Comprehensive Cancer Centre (Porto.CCC) & RISE@CI-IPOP (Health Research Network), R. Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal
- Department of Pathology and Molecular Immunology, School of Medicine & Biomedical Sciences, University of Porto (ICBAS-UP), Rua Jorge Viterbo Ferreira 228, 4050-513 Porto, Portugal
| | - Rui Henrique
- Department of Pathology, Portuguese Oncology Institute of Porto (IPO Porto), R. Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal
- Cancer Biology and Epigenetics Group, IPO Porto Research Center (CI-IPOP), Portuguese Oncology Institute of Porto (IPO Porto)/Porto Comprehensive Cancer Centre (Porto.CCC) & RISE@CI-IPOP (Health Research Network), R. Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal
- Department of Pathology and Molecular Immunology, School of Medicine & Biomedical Sciences, University of Porto (ICBAS-UP), Rua Jorge Viterbo Ferreira 228, 4050-513 Porto, Portugal
| | - Carmen Jerónimo
- Department of Pathology, Portuguese Oncology Institute of Porto (IPO Porto), R. Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal
- Cancer Biology and Epigenetics Group, IPO Porto Research Center (CI-IPOP), Portuguese Oncology Institute of Porto (IPO Porto)/Porto Comprehensive Cancer Centre (Porto.CCC) & RISE@CI-IPOP (Health Research Network), R. Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal
- Department of Pathology and Molecular Immunology, School of Medicine & Biomedical Sciences, University of Porto (ICBAS-UP), Rua Jorge Viterbo Ferreira 228, 4050-513 Porto, Portugal
| | - Luisa Alejandra Helguero
- iBiMED—Institute of Biomedicine, University of Aveiro, Agra do Crasto 30, 3810-193 Aveiro, Portugal
- Correspondence: ; Tel.: +35-1-234-247-240 (ext. 22112)
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D’Angelo A, Giudici F, Chapman R, Darlow J, Kilili H, Sobhani N, Cinelli M, Cappelletti MR, Strina C, Milani M, Generali D. Clinico-Immunological Effects of a Single-Agent CDK4/6 Inhibitor in Advanced HR+/HER2- Breast Cancer Based on a Window of Opportunity Study. Curr Issues Mol Biol 2022; 44:4255-4267. [PMID: 36135204 PMCID: PMC9497904 DOI: 10.3390/cimb44090292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/07/2022] [Accepted: 09/08/2022] [Indexed: 11/24/2022] Open
Abstract
Background: Cyclin-dependent kinase 4/6 inhibitors (CDK4/6 i), abemaciclib, palbociclib, and ribociclib, have been FDA-approved for the treatment of hormone receptor-positive (HR+), HER2−negative (HER2−) advanced breast cancer (aBC). This targeted therapy has revived hope in those aBC patients who did not respond to standard therapies. Interestingly, when administered as a single agent, CDK4/6 modulated several peripheral blood cells after a short-course treatment of 28 days. However, the impact of these immune effects has yet to be thoroughly investigated. Methods: We administered abemaciclib, palbociclib, and ribociclib monotherapy to 23 patients with HR+/HER2− metastatic breast cancer. The aim is to investigate the impact of on-treatment modifications on peripheral blood cells and their composite scores in patients after a 28-day course of CDK4/6 i alone. Results: In the current study, we observed a significant decrease in neutrophils (p-value < 0.001) for patients treated with abemaciclib, palbociclib, and ribociclib. An overall decrease of Tregs was observed and potentially linked to palbociclib treatment. The neutrophile to lymphocyte (N/L) ratio was also decreased overall and potentially linked to abemaciclib and palbociclib treatment. Platelets were decreased in patients administered with abemaciclib. Notably, the radiometabolic response was available only for those patients treated with ribociclib and abemaciclib, and only those lesions treated with ribociclib reached statistical relevance. Conclusions: Our study strongly supports the notion that CDK4/6 inhibitors induce tumour immune modulation. N/L ratio and platelet levels decreased due to treatment. Future studies should test whether patients would benefit from immunomodulators in association with CDK4/6 agents in a larger clinical trial. Moreover, the CDK4/6-induced immune modulation could also be considered a potential predictive clinical factor in HR+/HER2− advanced breast cancer.
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Affiliation(s)
- Alberto D’Angelo
- Department of Biology and Biochemistry, University of Bath, Bath BA2 7 AY, UK
- Correspondence:
| | - Fabiola Giudici
- Department of Biostatistics and Epidemiology, Gustave Roussy, Paris-Saclay University, 91190 Gif-sur-Yvette, France
| | - Robert Chapman
- Department of Medicine, The Princess Alexandra Hospital, Harlow CM20 1 QX, UK
| | - Jacob Darlow
- Department of Biology and Biochemistry, University of Bath, Bath BA2 7 AY, UK
| | - Huseyin Kilili
- Milner Centre for Evolution, Department of Biology and Biochemistry, University of Bath, Bath BA2 7 AY, UK
| | - Navid Sobhani
- Section of Epidemiology and Population Science, Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Mattia Cinelli
- Department of Biology and Biochemistry, University of Bath, Bath BA2 7 AY, UK
| | - Maria Rosa Cappelletti
- UOC Multidisciplinare di Patologia Mammaria e Ricerca Traslazionale, Azienda Socio-Sanitaria Territoriale di Cremona, 126100 Cremona, Italy
| | - Carla Strina
- UOC Multidisciplinare di Patologia Mammaria e Ricerca Traslazionale, Azienda Socio-Sanitaria Territoriale di Cremona, 126100 Cremona, Italy
| | - Manuela Milani
- UOC Multidisciplinare di Patologia Mammaria e Ricerca Traslazionale, Azienda Socio-Sanitaria Territoriale di Cremona, 126100 Cremona, Italy
| | - Daniele Generali
- UOC Multidisciplinare di Patologia Mammaria e Ricerca Traslazionale, Azienda Socio-Sanitaria Territoriale di Cremona, 126100 Cremona, Italy
- Dipartimento Universitario Clinico di Scienze Mediche, Chirurgiche e della Salute, Università degli Studi di Trieste, 34129 Trieste, Italy
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Gong Z, Xin R, Li L, Lv L, Wu X. Platelet-to-lymphocyte ratio associated with the clinicopathological features and prognostic value of breast cancer: A meta-analysis. Int J Biol Markers 2022; 37:339-348. [PMID: 35971299 DOI: 10.1177/03936155221118098] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The association of platelet-to-lymphocyte ratio (PLR) with the clinicopathological features and prognosis in patients with breast cancer was evaluated. METHOD Related studies were searched from PubMed, Embase, Cochrane Library, and Web of Science up to July 1, 2021. Then, basic characteristic and prognostic data were extracted from the included studies. We synthesized and compared primary outcomes such as overall survival. Subgroups analyses in pathology, geographical area, follow-up time, and sample size were conducted. The pooled hazard ratio (HR), odds ratio (OR), and 95% confidence interval (CI) served as measures to assess the relationship of PLR with prognosis and clinicopathological features of breast cancer patients. After literature retrieval and selection, 20 studies with 7484 patients were included in this meta-analysis. RESULTS High PLR was significantly related to poor overall survival (HR = 1.88; 95% CI 1.61, 2.19; P < 0.001) in breast cancer patients. Also, high PLR was associated with lymph node metastasis (LNM) (OR = 1.82; 95% CI 1.32, 2.52; P < 0.001), advanced tumor-node-metastasis (TNM) stage (OR = 1.89; 95% CI 1.25, 2.87; P = 0.003), and distant metastasis (OR = 1.76; 95% CI 1.14, 2.72; P = 0.01) in breast cancer. The stability and reliability of results in this meta-analysis were confirmed by sensitivity analysis. CONCLUSION Elevated PLR is related to a poor prognosis and a higher risk of LNM, advanced TNM stage, and distant metastasis in breast cancer patients. Therefore, PLR can be identified as a biomarker with potential prognostic value in breast cancer.
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Affiliation(s)
- Zhixun Gong
- Department of Radiotherapy, The Second Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China
| | - Ruomei Xin
- Department of Nursing, Danzhou People's Hospital, Danzhou, Hainan, China
| | - Long Li
- Union, The Second Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China
| | - Liping Lv
- Department of Radiotherapy, The Second Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China
| | - Xinni Wu
- Department of Physical Examination, The Second Affiliated Hospital of Hainan Medical College, Haikou, Hainan, China
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9
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Zhu M, Chen L, Kong X, Wang X, Li X, Fang Y, Wang J. The Systemic Immune-Inflammation Index is an Independent Predictor of Survival in Breast Cancer Patients. Cancer Manag Res 2022; 14:775-820. [PMID: 35241935 PMCID: PMC8887616 DOI: 10.2147/cmar.s346406] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 01/11/2022] [Indexed: 12/13/2022] Open
Abstract
Purpose The current investigation examines the potential clinical value and prognostic significance of a systemic immune-inflammation index (SII) in patients with breast cancer. Patients and Methods A total of 477 individuals underwent neoadjuvant chemotherapy, and 308 individuals did not at our center between January 1998 and December 2016 were selected. An optimized SII threshold was generated using a receiver operating characteristic curve (ROC). The relationship between various factors and breast cancer in predicting disease-free survival (DFS) and overall survival (OS) were analyzed. Results The SII < 560 group (Low SII group) and SII ≥ 560 group (High SII group) are divided according to the threshold value. SII was an independent predictor for breast cancer DFS and OS based on univariate and multivariate analyses. Low SII patients had higher mean DFS and OS in contrast to those in the high SII groups (46.65 vs 27.37 months and 69.92 vs 49.53 months). Those in the low SII cohort who also had early or advanced breast cancer, different molecular subtypes, and with or without lymph vessel invasion all had higher mean survival time of DFS and OS in contrast to those with raised SII values (P<0.05). The mean DFS and OS durations also varied based on different Miller and Payne grades (MPG) (P <0.005), and different response groups (P<0.05). Conclusion SII can be used as an easily accessible and minimally invasive potential prognostic factor in individuals with breast cancer and may also guide clinicians in treating and prognosticating patients with breast cancer.
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Affiliation(s)
- Mengliu Zhu
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, People’s Republic of China
| | - Li Chen
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, People’s Republic of China
- Department of Thyroid and Breast Surgery, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People’s Republic of China
| | - Xiangyi Kong
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, People’s Republic of China
| | - Xiangyu Wang
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, People’s Republic of China
| | - Xingrui Li
- Department of Thyroid and Breast Surgery, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People’s Republic of China
| | - Yi Fang
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, People’s Republic of China
| | - Jing Wang
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, People’s Republic of China
- Correspondence: Jing Wang; Yi Fang, Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, People’s Republic of China, Email ;
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10
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Guo F, Du J, Liu L, Gou Y, Zhang M, Sun W, Yu H, Fu X. lncRNA OR3A4 Promotes the Proliferation and Metastasis of Ovarian Cancer Through KLF6 Pathway. Front Pharmacol 2021; 12:727876. [PMID: 34776953 PMCID: PMC8578722 DOI: 10.3389/fphar.2021.727876] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 08/26/2021] [Indexed: 12/11/2022] Open
Abstract
Aim: Ovarian cancer is a collaborative malignant tumor of the female reproductive system in clinical research. Some clinical studies have shown that OR3A4, which is a cancer-causing lncRNA, plays a major role in promoting the occurrence and development of a variety of tumors. And we also expressed the view that it expressed in ovarian tissue. However, the function of OR3A4 in ovarian cancer remains unclear. Methods and Results: To further verify the function of lncRNA OR3A4 in ovarian cancer, we established the xenograft model in the zebra fish. In this study, cells transformed with OR3A4 shRNA plasmids were transplanted into the zebra fish, and the cell proliferation and migration ability were significantly reduced compared to the empty vector. While knocking out OR3A4, we further downregulated its expression by siRNA of KLF6. Our study found that the knocked out OR3A4 resulted in a decrease in cell proliferation and migration level, which can be found in the downregulated expression of KLF6. We also verify the relationship between OR3A4 and circulating tumor cells in the zebra fish xenograft model, the results indicate that lncRNA OR3A4 may be involved in the resistance of ovarian cancer to complain. Conclusion: lncRNA OR3A4 promotes the proliferation and metastasis of ovarian cancer through the KLF6 pathway.
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Affiliation(s)
- Fangfang Guo
- Edmond H. Fischer Signal Transduction Laboratory, College of Life Sciences, Jilin University, Changchun, China.,Department of Gynecology, Xinhua Hospital Affiliated to Dalian University, Dalian, China
| | - Jianan Du
- Department of Molecular Biology, College of Basic Medical Sciences Jilin University, Changchun, China.,Jilin Province Zebrafish Genetic Engineering Laboratory, Jilin Provincial Development and Reform Commission, Changchun, China
| | - Lingling Liu
- Department of Molecular Biology, College of Basic Medical Sciences Jilin University, Changchun, China.,Jilin Province Zebrafish Genetic Engineering Laboratory, Jilin Provincial Development and Reform Commission, Changchun, China
| | - Yawei Gou
- Department of Molecular Biology, College of Basic Medical Sciences Jilin University, Changchun, China.,Jilin Province Zebrafish Genetic Engineering Laboratory, Jilin Provincial Development and Reform Commission, Changchun, China
| | - Mingming Zhang
- Department of Molecular Biology, College of Basic Medical Sciences Jilin University, Changchun, China.,Jilin Province Zebrafish Genetic Engineering Laboratory, Jilin Provincial Development and Reform Commission, Changchun, China
| | - Wei Sun
- Department of Molecular Biology, College of Basic Medical Sciences Jilin University, Changchun, China.,Jilin Province Zebrafish Genetic Engineering Laboratory, Jilin Provincial Development and Reform Commission, Changchun, China
| | - Hongmei Yu
- Department of Blood Transfusion, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Xueqi Fu
- Edmond H. Fischer Signal Transduction Laboratory, College of Life Sciences, Jilin University, Changchun, China
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11
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Li X, Tan Q, Li H, Yang X. Predictive Value of Pretreatment Peripheral Neutrophil-to-Lymphocyte Ratio for Response to Neoadjuvant Chemotherapy and Breast Cancer Prognosis. Cancer Manag Res 2021; 13:5889-5898. [PMID: 34349562 PMCID: PMC8326279 DOI: 10.2147/cmar.s313123] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 07/16/2021] [Indexed: 02/05/2023] Open
Abstract
Background Neutrophil-to-lymphocyte ratio (NLR) is connected with the response to neoadjuvant chemotherapy (NAC) and prognosis. In addition, residual lymph node burden after NAC is likely important for prognosis. However, most studies have focused on the predictive value of NLR for NAC pathological complete response (pCR) rate. The relationship between NLR and post-operative residual lymph node ratio (LNR), and their prognostic values remain to be determined. Methods We retrospectively studied 282 patients with breast cancer who underwent curative surgery after NAC from 2008 to 2018. We collected pretreatment NLR in peripheral blood, the response to NAC, and the amount of axillary lymph nodes (positive and total) from patients who received axillary lymph node dissection (ALND). We followed up all patients from 2 to 116 months, with an average of 63 months. We analyzed the predictive value of pretherapeutic NLR in peripheral blood on the response of NAC, including pCR rate and postoperative LNR. The prognostic value of NLR and LNR was also analyzed. Results A pCR was achieved in 20 (27.0%) of 74 patients with low NLR, and 34 (16.3%) of 208 with high NLR (P = 0.045). In luminal A and luminal B tumors, patients with high NLR tended to have elevated LNR (LNR>0.5; P=0.041). In Kaplan–Meier analysis, overall survival of patients with low NLR (NLR < 1.8; P = 0.033) was longer than that of patients with high NLR (NLR ≥ 1.8). Moreover, by multivariable analysis, LNR was negatively correlated with overall survival (P < 0.05) and disease-free survival (DFS) (P < 0.05). Conclusion pCR rate, post-operative remaining lymph node involvement and overall survival in all patients who received NAC may be predicted by NLR. Low NLR and LNR may suggest favorable outcomes.
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Affiliation(s)
- Xiaomin Li
- Department of Breast Surgery, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Qiuwen Tan
- Department of Breast Surgery, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Hongjiang Li
- Department of Breast Surgery, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Xiaoqin Yang
- Department of Breast Surgery, West China Hospital, Sichuan University, Chengdu, People's Republic of China
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12
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Alkan ŞB, Artaç M, Rakıcıoğlu N. Dietary Antioxidant Capacity and Serum Inflammatory Biomarkers Levels in Cancer Survivors. Nutr Cancer 2021; 74:1243-1251. [PMID: 34278894 DOI: 10.1080/01635581.2021.1952443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This study aimed to compare the dietary intake of carotenoids, tocopherols, ascorbic acid, flavonoids, and dietary total antioxidant capacity (dTAC) and to evaluate relationship of dTAC with serum inflammatory biomarkers in patients with gastrointestinal system (GIS) and non-GIS cancer. In total, 104 adult cancer survivors (52 GIS and 52 non-GIS cancer cases) were included. 24-hour dietary recalls were obtained and dTAC was calculated on the basis of oxygen radical absorption capacity (ORAC), Trolox equivalent antioxidant capacity (TEAC), total radical-trapping antioxidant parameter (TRAP), ferric reducing antioxidant potential (FRAP), and vitamin C equivalents (VCE). Serum C-reactive protein (CRP) level, neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) were used as inflammatory biomarkers. Routinely analyzed serum CRP, neutrophil, lymphocyte, and platelet levels every day in hospital biochemistry laboratory were obtained from patients' file. There was no significant difference between patients with GIS and non-GIS cancer in terms of dietary intake of carotenoids, tocopherols, and flavonoids. While there was no significant difference between groups in terms of the mean dietary ORAC, TEAC, and FRAP, the mean TRAP of patients with GIS cancer was significantly higher than patients with non-GIS cancer. Serum inflammatory markers (CRP and NLR) were found to have an inverse relationship with dTAC.
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Affiliation(s)
- Şenay Burçin Alkan
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Necmettin Erbakan University, Konya, Turkey
| | - Mehmet Artaç
- Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Neslişah Rakıcıoğlu
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
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13
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Kaytaz Tekyol K, Gurleyik G, Aktaş A, Aker F, Tanrikulu E, Tekyol D. Pathological Complete Response to Neoadjuvant Chemotherapy in Patients With Breast Cancer: The Relationship Between Inflammatory Biomarkers and Molecular Subtypes. Cureus 2021; 13:e14774. [PMID: 34094739 PMCID: PMC8164848 DOI: 10.7759/cureus.14774] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Purpose Among patients with breast cancer, pathological complete response (pCR) to neoadjuvant chemotherapy (NAC) is an important prognostic predictor of survival. This study aimed to investigate the relationship between platelet-lymphocyte ratio (PLR) and neutrophil-lymphocyte ratio (NLR) along with overall pCR. Method A total of 150 patients with breast cancer who were first administered NAC and then operated on were retrospectively evaluated. Neutrophil-lymphocyte ratio and PLR obtained from the complete blood count analysis performed immediately before NAC treatment were analyzed. The cut-off value was calculated as 150 for PLR and 2.24 for NLR. We studied the predictive value of NLR and PLR levels for the pathologic response of breast cancer to NAC. Results Pathological complete response was observed in 34.7% (n = 52) of the patients, pCR in the breast in 42.7% (n = 64), and that in the axilla in 44% (n = 66). There was a statistically significant difference between the pCR rates according to the PLR levels (p = 0.013). In addition, a statistically significant difference was found in the pCR rates in the breast and axilla according to PLR levels (p = 0.018, p = 0.009). Patients with low PLR in the human epidermal growth factor receptor 2 (HER-2) group had significantly higher axillary pCR rates than in those with high PLR (p = 0.019). Conclusions A low PLR level showed high chemotherapy sensitivity independent of molecular subtypes in the treatment of breast cancer with NAC. The PLR level can serve as a predictive marker of the therapeutic effect of NAC on the breast and axilla. Low PLR levels in HER-2 enriched groups can predict pCR in the axilla.
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Affiliation(s)
| | - Gunay Gurleyik
- General Surgery, University of Health Sciences, Haydarpaşa Numune Training and Research Hospital, İstanbul, TUR
| | - Ayşegül Aktaş
- General Surgery, University of Health Sciences, Haydarpaşa Numune Training and Research Hospital, İstanbul, TUR
| | - Fugen Aker
- Pathology, University of Health Sciences, Haydarpaşa Numune Training and Research Hospital, İstanbul, TUR
| | - Eda Tanrikulu
- Oncology, University of Health Sciences, Haydarpaşa Numune Training and Research Hospital, İstanbul, TUR
| | - Davut Tekyol
- Emergency Medicine, University of Health Sciences, Haydarpaşa Numune Training and Research Hospital, İstanbul, TUR
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14
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Wang P, Yang M, Wang X, Zhao Z, Li M, Yu J. A nomogram for the predicting of survival in patients with esophageal squamous cell carcinoma undergoing definitive chemoradiotherapy. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:233. [PMID: 33708860 PMCID: PMC7940874 DOI: 10.21037/atm-20-1460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background Definitive chemoradiotherapy (dCRT) is widely accepted for esophageal squamous cell carcinoma (ESCC), although the outcomes can vary. Therefore, we aimed to develop a nomogram for the pre-treatment prediction of survival after dCRT for ESCC. Methods This retrospective study evaluated 204 patients (169 patients in a primary cohort and 35 patients in a validation cohort) who received dCRT for ESCC between July 2013 and June 2017. Results Pre-treatment parameters that predicted long-term survival in this setting were body mass index (BMI), absolute lymphocyte count (ALC), neutrophil-to-lymphocyte ratio (NLR), wall thickness, concurrent chemoradiotherapy, radiotherapy modality, and American Joint Committee on Cancer (AJCC) stage. The nomogram incorporated these factors and provided C-index values of 0.691 [95% confidence interval (CI): 0.641-0.740] in the primary cohort and 0.816 (95% CI: 0.700-0.932) in the validation cohort. The calibration curve analysis revealed that the nomogram had good ability to predict 2-year progression-free survival (PFS). The nomogram also performed better than the AJCC staging system by the C-index values (0.691 vs. 0.560) and the area under the curve values (0.702 vs. 0.576). Decision curve analysis (DCA) also indicated that the nomogram had better clinical utility. Conclusions These results suggest that pre-treatment parameters may help predict the efficacy of dCRT for ESCC. Furthermore, as the nomogram provided better prognostic accuracy than the AJCC staging system, the nomogram may be useful in clinical practice for prognostication among patients who are going to receive dCRT for ESCC.
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Affiliation(s)
- Peiliang Wang
- Cheeloo College of Medicine, Shandong University, Jinan, China.,Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Maoqi Yang
- School of Pharmacy, Yantai University, Yantai, China
| | - Xin Wang
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China.,Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China
| | - Zongxing Zhao
- Cheeloo College of Medicine, Shandong University, Jinan, China.,Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Minghuan Li
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Jinming Yu
- Cheeloo College of Medicine, Shandong University, Jinan, China.,Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
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15
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Jaillon S, Ponzetta A, Di Mitri D, Santoni A, Bonecchi R, Mantovani A. Neutrophil diversity and plasticity in tumour progression and therapy. Nat Rev Cancer 2020; 20:485-503. [PMID: 32694624 DOI: 10.1038/s41568-020-0281-y] [Citation(s) in RCA: 559] [Impact Index Per Article: 139.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/04/2020] [Indexed: 12/11/2022]
Abstract
Neutrophils play a key role in defence against infection and in the activation and regulation of innate and adaptive immunity. In cancer, tumour-associated neutrophils (TANs) have emerged as an important component of the tumour microenvironment. Here, they can exert dual functions. TANs can be part of tumour-promoting inflammation by driving angiogenesis, extracellular matrix remodelling, metastasis and immunosuppression. Conversely, neutrophils can also mediate antitumour responses by direct killing of tumour cells and by participating in cellular networks that mediate antitumour resistance. Neutrophil diversity and plasticity underlie the dual potential of TANs in the tumour microenvironment. Myeloid checkpoints as well as the tumour and tissue contexture shape neutrophil function in response to conventional therapies and immunotherapy. We surmise that neutrophils can provide tools to tailor current immunotherapy strategies and pave the way to myeloid cell-centred therapeutic strategies, which would be complementary to current approaches.
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Affiliation(s)
- Sebastien Jaillon
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy.
- Humanitas Clinical and Research Center IRCCS, Rozzano (MI), Italy.
| | - Andrea Ponzetta
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
- Humanitas Clinical and Research Center IRCCS, Rozzano (MI), Italy
| | - Diletta Di Mitri
- Humanitas Clinical and Research Center IRCCS, Rozzano (MI), Italy
| | - Angela Santoni
- Dipartimento di Medicina Molecolare Istituto Pasteur-Fondazione Cenci Bolognetti, Università di Roma 'La Sapienza', Rome, Italy
- IRCCS Neuromed, Pozzilli (IS), Italy
| | - Raffaella Bonecchi
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
- Humanitas Clinical and Research Center IRCCS, Rozzano (MI), Italy
| | - Alberto Mantovani
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy.
- Humanitas Clinical and Research Center IRCCS, Rozzano (MI), Italy.
- The William Harvey Research Institute, Queen Mary University of London, London, UK.
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16
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Hua X, Long ZQ, Huang X, Deng JP, Wen W, He ZY, Guo L, Zhang WW, Lin HX. The preoperative systemic inflammation response index (SIRI) independently predicts survival in postmenopausal women with breast cancer. Curr Probl Cancer 2020; 44:100560. [PMID: 32122667 DOI: 10.1016/j.currproblcancer.2020.100560] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 09/06/2019] [Accepted: 01/08/2020] [Indexed: 11/21/2022]
Abstract
The recently developed preoperative systemic inflammation response index (SIRI) was reported as a useful biomarker that could predict survival in certain types of malignant tumors. However, the prognostic value of preoperative SIRI in postmenopausal breast cancer remains unclear. This study aimed to explore the relationship between SIRI and survival in postmenopausal patients with breast cancer. A total of 390 postmenopausal patients with breast cancer who underwent a mastectomy at Sun Yat-sen University Cancer Center were retrospectively studied. SIRI was based on peripheral neutrophil, monocyte, and lymphocyte counts, calculated as: neutrophil count × monocyte count/lymphocyte count. The best cut-off value for SIRI was determined using receiver operating characteristic curve analysis. Patients were divided into 2 groups:Low SIRI < 0.54 and high SIRI > 0.54. High SIRI was significantly related to progesterone receptor status. Kaplan-Meier survival analysis showed that T stage, N stage, clinical stage, carcinoembryonic antigen, estrogen receptor, progesterone receptor, endocrinotherapy, and SIRI were significantly correlated with overall survival (OS). Multivariate analysis showed that SIRI could also independently predict OS. Preoperative SIRI may be a reliable predictor of OS in postmenopausal patients with operable breast cancer to provide personalized prognostication and to assist in the formulation of a clinical treatment strategy.
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Affiliation(s)
- Xin Hua
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, China; Department of Radiotherapy, Sun Yat-sen University Cancer Center, China
| | - Zhi-Qing Long
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, China; Department of Radiotherapy, Sun Yat-sen University Cancer Center, China
| | - Xin Huang
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, China
| | - Jia-Peng Deng
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, China; Department of Radiotherapy, Sun Yat-sen University Cancer Center, China
| | - Wen Wen
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, China; Department of Radiotherapy, Sun Yat-sen University Cancer Center, China
| | - Zhen-Yu He
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, China; Department of Radiotherapy, Sun Yat-sen University Cancer Center, China
| | - Ling Guo
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, China; Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, China
| | - Wen-Wen Zhang
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, China; Department of Radiotherapy, Sun Yat-sen University Cancer Center, China.
| | - Huan-Xin Lin
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, China; Department of Radiotherapy, Sun Yat-sen University Cancer Center, China.
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17
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Radiotherapy-Induced High Neutrophil-to-Lymphocyte Ratio is a Negative Prognostic Factor in Patients with Breast Cancer. Cancers (Basel) 2020; 12:cancers12071896. [PMID: 32674376 PMCID: PMC7409084 DOI: 10.3390/cancers12071896] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 07/11/2020] [Indexed: 12/12/2022] Open
Abstract
Radiotherapy (RT) is the standard of care following breast-conserving operation in breast cancer patients. The neutrophil-to-lymphocyte ratio (NLR) reflects the systemic change caused as a result of the radiotherapy. We aimed to evaluate the association between RT and the change in NLR following the receipt of RT, and to investigate the prognostic impact. We retrospectively reviewed NLR values of breast cancer patients taken before the administration of the first and the last session of RT. The cut-off point for the NLR was determined using the Youden index and receiver operating characteristic (ROC) curve within the training set. Recurrence-free survival (RFS), distant metastasis free survival, and overall survival were the main outcomes. Patients with an NLR higher than 3.49 after RT were classified to an RT-induced high NLR group and showed a significantly higher recurrence rate compared to those with low NLR (p < 0.001). In a multivariate Cox proportional hazards model, RT-induced high NLR remained a significant prognostic factor (HR 2.194, 95% CI 1.230–3.912, p = 0.008 for tumor recurrence. We demonstrated that an increase in NLR over the course of RT has a negative impact on survival, putting these patients with RT-susceptible host immunity at a higher risk of tumor recurrence.
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18
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Li L, Wang J, Meng S, Li Z, Huang Z, Sun J, Wang G, Luo F, Yang K. Peripheral Blood Leukocytes and Platelets Serve as Prognostic Factors in Breast Cancer. Cancer Biother Radiopharm 2020; 36:167-173. [PMID: 32608994 DOI: 10.1089/cbr.2019.3032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Background: Tumor-infiltrating lymphocytes have been reported to be associated with response to neoadjuvant chemotherapy and survival in breast cancer (BC) patients. However, little is known about the value of peripheral blood parameter in predicting the prognosis in BC. Methods: In this study, parameters of complete blood count from 417 BC patients with a median 7.6-year follow-up after surgery were collected and correlated with patient survival. Results: It was found that leukocyte counts were positively correlated with disease-free survival (DFS, p = 0.016) and overall survival (OS, p = 0.014), whereas platelet counts were negatively correlated with DFS (p = 0.003) and OS (p = 0.082) in BC. Leukocyte and platelet counts were independent prognostic factors for the BC patient survival. Besides, the prognostic value of leukocyte and platelet counts was further evaluated in the BC patients with different molecular subtypes. Together, BC patients with high leukocyte counts and low platelet counts had better DFS (p = 0.001) and OS (p = 0.017) than the other patients. Conclusion: Parameters of complete blood count could be acquired easily and serve as cost-effective prognostic biomarkers in BC.
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Affiliation(s)
- Li Li
- Department of Thyroid and Breast Surgery, The First People's Hospital of Yunnan Province (the Affiliated Kunhua Hospital of Kunming University of Science and Technology), Kunming, China
| | - Jianjun Wang
- Department of Thyroid and Breast Surgery, The First People's Hospital of Yunnan Province (the Affiliated Kunhua Hospital of Kunming University of Science and Technology), Kunming, China
| | - Shaoda Meng
- Department of Thyroid and Breast Surgery, The First People's Hospital of Yunnan Province (the Affiliated Kunhua Hospital of Kunming University of Science and Technology), Kunming, China
| | - Zhongquan Li
- Department of Thyroid and Breast Surgery, The People's Armed Police Hospital of Yunnan Province, Kunming, China
| | - Zhenfan Huang
- Department of Thyroid and Breast Surgery, The First People's Hospital of Yunnan Province (the Affiliated Kunhua Hospital of Kunming University of Science and Technology), Kunming, China
| | - Jiangxia Sun
- Department of Thyroid and Breast Surgery, The First People's Hospital of Yunnan Province (the Affiliated Kunhua Hospital of Kunming University of Science and Technology), Kunming, China
| | - Guowei Wang
- Department of Thyroid and Breast Surgery, The First People's Hospital of Yunnan Province (the Affiliated Kunhua Hospital of Kunming University of Science and Technology), Kunming, China
| | - Feipeng Luo
- Department of Surgery Four, The Second People's Hospital of Baoshan City, Baoshan, China
| | - Kunxian Yang
- Department of Thyroid and Breast Surgery, The First People's Hospital of Yunnan Province (the Affiliated Kunhua Hospital of Kunming University of Science and Technology), Kunming, China
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19
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The complexity of neutrophils in health and disease: Focus on cancer. Semin Immunol 2020; 48:101409. [PMID: 32958359 PMCID: PMC7500440 DOI: 10.1016/j.smim.2020.101409] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 08/21/2020] [Accepted: 09/04/2020] [Indexed: 12/14/2022]
Abstract
Neutrophils are essential soldiers of the immune response and their role have long been restricted to their activities in defence against microbial infections and during the acute phase of the inflammatory response. However, increasing number of investigations showed that neutrophils are endowed with plasticity and can participate in the orchestration of both innate and adaptive immune responses. Neutrophils have an impact on a broad range of disorders, including infections, chronic inflammations, and cancer. Neutrophils are present in the tumour microenvironment and have been reported to mediate both pro-tumour and anti-tumour responses. Neutrophils can contribute to genetic instability, tumour cell proliferation, angiogenesis and suppression of the anti-tumour immune response. In contrast, neutrophils are reported to mediate anti-tumour resistance by direct killing of tumour cells or by engaging cooperative interactions with other immune cells. Here we discuss the current understandings of neutrophils biology and functions in health and diseases, with a specific focus on their role in cancer biology and their prognostic significance in human cancer.
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20
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Myojin M, Horimoto Y, Ito M, Kitano S, Ishizuka Y, Sasaki R, Uomori T, Himuro T, Murakami F, Nakai K, Iijima K, Saito M. Neutrophil-to-lymphocyte ratio and histological type might predict clinical responses to eriburin-based treatment in patients with metastatic breast cancer. Breast Cancer 2020; 27:732-738. [PMID: 32108306 DOI: 10.1007/s12282-020-01069-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 02/19/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Metastatic breast cancer (MBC) is generally considered to be incurable. Although many options are available for treating MBC, physicians often encounter difficulties in choosing the most appropriate treatment because the MBCs of individual patients respond differently even to the same treatments. Thus, predictive markers for therapeutic efficacy are urgently needed. Neutrophil- and platelet-to-lymphocyte ratios (NLR and PLR, respectively), have been studied and established as prognostic markers for breast cancer patients but whether either or both of these markers are predictive of treatment responses is still unclear. Herein, we investigated predictive markers for eribulin-based treatment responsiveness in patients with MBC, by examining clinicopathological features, including several markers of immunocompetent cells in peripheral blood. METHODS Clinicopathological features of the 104 patients with metastatic/Stage IV breast cancer given eribulin-based regimens were investigated in relation to clinical responses to eribulin-based treatments and progression-free-survival (PFS). RESULTS Special histological types and high NLR at baseline were independently related to poor clinical responses to the treatments (p = 0.023 and 0.039, respectively). The Cox hazard model revealed that patients with oestrogen receptor (ER)-negative tumours and high NLR, monocyte-to-lymphocyte ratio (MLR) and PLR showed significantly shorter PFS (p = 0.021, 0.005, 0.008 and 0.030, respectively). On multivariate analysis, only ER status and NLR remained independent factors related to PFS (p = 0.011 and 0.003, respectively). CONCLUSIONS Our data revealed that special histological types and high NLR might be factors related to low responsiveness to eribulin-based regimens in patients with MBC.
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Affiliation(s)
- Mayu Myojin
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Yoshiya Horimoto
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
| | - Mayuko Ito
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Shigehisa Kitano
- Department of Experimental Therapeutics, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Tokyo, Japan
| | - Yumiko Ishizuka
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Ritsuko Sasaki
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Toshitaka Uomori
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Takanori Himuro
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Fumi Murakami
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Katsuya Nakai
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Kotaro Iijima
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Mitsue Saito
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
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Chen L, Kong X, Yan C, Fang Y, Wang J. The Research Progress on the Prognostic Value of the Common Hematological Parameters in Peripheral Venous Blood in Breast Cancer. Onco Targets Ther 2020; 13:1397-1412. [PMID: 32104003 PMCID: PMC7028387 DOI: 10.2147/ott.s227171] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 01/06/2020] [Indexed: 12/26/2022] Open
Abstract
Breast carcinoma is one of the most malignant tumors, severely influencing the physical and mental health of people. The latest epidemiological and clinical studies have found that breast tumor and inflammation are determinate relationships with each other. Inflammation is an essential component of the tumor microenvironment, and the change of inflammatory cells might influence tumor progression, such as neoplastic cell proliferation, migration, invasion, the collapse of antitumor immunity, metastasis and so forth. Peripheral blood tests at the time of diagnosis and treatment can reflect inflammatory conditions within the neoplasm. Evaluation of peripheral blood parameters including white blood cell, neutrophil, lymphocyte, monocyte, platelet counts, as well as neutrophil-to-lymphocyte ratio (NLR), derived neutrophil-to-lymphocyte ratio (d-NLR) (neutrophil count divided by the result of white blood cell count minus neutrophil count), platelet-to-lymphocyte ratio (PLR) and lymphocyte-to-monocyte ratio (LMR), which are indicators of systematic inflammatory response, have been widely proposed as prognostic factors for many malignancies. To intensively study the relationship between the common markers in peripheral blood and the treatment or prognosis of breast cancer will have critical clinical significance and application prospect, and can provide useful information for the clinicians. Herein, we review the research progress in the prognostic role of the peripheral blood in breast cancer to provide a new method for the treatment and prognosis of breast cancer.
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Affiliation(s)
- Li Chen
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, People's Republic of China
| | - Xiangyi Kong
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, People's Republic of China
| | - Chengrui Yan
- Department of Neurosurgery, Peking University International Hospital, Beijing 100021, People's Republic of China
| | - Yi Fang
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, People's Republic of China
| | - Jing Wang
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, People's Republic of China
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Luo X, Yu B, Jiang N, Du Q, Ye X, Li H, Wang WQ, Zhai Q. Chemotherapy-Induced Reduction of Neutrophil-to-Lymphocyte Ratio Is Associated With Better Survival in Pancreatic Adenocarcinoma: A Meta-Analysis. Cancer Control 2020; 27:1073274820977135. [PMID: 33269614 PMCID: PMC8480367 DOI: 10.1177/1073274820977135] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 10/13/2020] [Accepted: 10/27/2020] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVES Numerous studies have suggested that an increase in neutrophil-to-lymphocyte ratio (NLR) before treatment is associated with worse survival in pancreatic adenocarcinoma (PAC). The aim of this study was to investigate the prognostic value of treatment-induced NLR change among PAC patients so as to better identify the characteristics of those who can benefit more from treatment. METHODS This meta-analysis was undertaken using the PRISMA statement. Previously published studies between the correlation of NLR change and patients' survival were searched in Pubmed, Embase, and Web of Science databases. RevMan 5.3 was used to conduct statistical analysis. RESULTS A total of 1213 patients with PAC from 6 retrospective studies were included in this meta-analysis. Four studies investigated the HR of pre-treatment NLR, demonstrating its prognostic impact on overall survival (OS) (HR = 2.21, 95%CI: 1.45-3.36). One study reported that an elevated post-treatment NLR was associated with poorer OS (HR = 1.28, 95%CI = 1.08-1.52). Pooled analysis indicated that NLR reduction might predict favorable survival in both the overall population (HR = 1.52, 95% CI: 1.34-1.73) and the subgroup treated with chemotherapy (HR = 1.50, 95% CI: 1.32-1.70). CONCLUSION Treatment-induced NLR change can act as an early predictor for PAC. Patients with reduced NLR after chemotherapy are expected to have better survival.
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Affiliation(s)
- Xin Luo
- Department of Pharmacy, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- College of Pharmacy, Fudan University, Shanghai, China
| | - Bo Yu
- Department of Pharmacy, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Nan Jiang
- Shanghai Institution of Planned Parenthood Research, Fudan University, Shanghai, China
| | - Qiong Du
- Department of Pharmacy, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xuan Ye
- Department of Pharmacy, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Huan Li
- Department of Pharmacy, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Wen-Quan Wang
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center; Shanghai Pancreatic Cancer Institute, Pancreatic Cancer Institute, Fudan University, Shanghai, China
| | - Qing Zhai
- Department of Pharmacy, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
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23
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Wang Y, Wang H, Yin W, Lin Y, Zhou L, Sheng X, Xu Y, Sha R, Lu J. Novel lymphocyte to red blood cell ratio (LRR), neutrophil to red blood cell ratio (NRR), monocyte to red blood cell ratio (MRR) as predictive and prognostic biomarkers for locally advanced breast cancer. Gland Surg 2019; 8:627-635. [PMID: 32042669 DOI: 10.21037/gs.2019.10.10] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Lymphocytes, neutrophils, and monocytes are vital effector cells in innate immunity. We postulated that lymphocyte to red blood cell ratio (LRR), neutrophil to red blood cell ratio (NRR), monocyte to red blood cell ratio (MRR) could represent the intensity of systemic inflammatory immunological reaction reflected through the lymphocyte, neutrophil and monocyte respectively. This study aimed to access the predictive and prognostic value of LRR, NRR, MRR and LRR-NRR-MRR score for locally advanced breast cancer. Methods A total of 137 patients from two clinical trials SHPD002 and SHPD003 were included. Logistic regression analysis was used to evaluate the association between ratios and pathological complete response (pCR). Disease-free survival (DFS) and overall survival (OS) were estimated by Kaplan-Meier method and cox regression analysis. Results Lower LRR-NRR-MRR score (OR =0.593; 95% CI: 0.369-0.954; P=0.031) was more easily to achieve pCR in multivariate analysis. Lower LRR (P=0.022), NRR (P=0.027) and MRR (P=0.024) were significantly associated with better DFS. LRR-NRR-MRR score was an independently prognostic factor for both DFS (HR =3.318; 95% CI: 1.601-6.876; P=0.001) and OS (HR =3.160; 95% CI: 1.030-9.696; P=0.044). Conclusions The LRR-NRR-MRR score could be identified as a new predictive biomarker for the therapeutic effect of neoadjuvant therapy and an independent prognostic factor for both DFS and OS for locally advanced breast cancer.
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Affiliation(s)
- Yaohui Wang
- Department of Breast Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
| | - Haofeng Wang
- Department of Breast Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
| | - Wenjin Yin
- Department of Breast Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
| | - Yanping Lin
- Department of Breast Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
| | - Liheng Zhou
- Department of Breast Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
| | - Xiaonan Sheng
- Department of Breast Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
| | - Yaqian Xu
- Department of Breast Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
| | - Rui Sha
- Department of Breast Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
| | - Jinsong Lu
- Department of Breast Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
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Peng Y, Chen R, Qu F, Ye Y, Fu Y, Tang Z, Wang Y, Zong B, Yu H, Luo F, Liu S. Low pretreatment lymphocyte/monocyte ratio is associated with the better efficacy of neoadjuvant chemotherapy in breast cancer patients. Cancer Biol Ther 2019; 21:189-196. [PMID: 31684807 DOI: 10.1080/15384047.2019.1680057] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
The combination of some parameters, including the neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), lymphocyte to monocyte ratio (LMR) and neutrophil to monocyte ratio (NMR), which are associated with patient prognosis, our goal is to find the best indicator to predict the efficacy of neoadjuvant chemotherapy(NAC)in breast cancer patients. A cohort of 808 breast cancer patients treated with NAC and subsequent surgery was analyzed retrospectively. In addition, 2424 people without breast cancer served as the normal group, which included three-fold more individuals compared with the breast cancer group. Receiver operating characteristics (ROC) curves were used to determine the optimal cutoff values of inflammatory markers and compare their predictive capacity. No significant differences in age, PLR, LMR and NMR were noted between the normal group and the patient group. However, the mean value of the NLR was significantly increased in breast cancer patients (2.28) compared with the normal population (2.04) (P < .05). The LMR was significantly associated with age (P = .003), menopausal status (P = .004), cT category (P = .017), cN category (P = .024) and response to NAC (P = .001). The multivariate analysis indicated that among these inflammatory markers, the LMR (6.1 < vs ≥ 6.1) was the only independent predictive factor for the efficacy of NAC (OR = 1.771, 95% CI = 1.273-2.464, P = .001). A low LMR is considered a favorable predicative factor of the efficacy of NAC in breast cancer patients.
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Affiliation(s)
- Yang Peng
- Department of Breast Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Rui Chen
- Department of Breast Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Fanli Qu
- Department of Breast Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ying Ye
- Department of Breast Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yong Fu
- Department of Breast Surgery, Dianjiang People's Hospital of Chongqing, Chongqing, China
| | - Zhenrong Tang
- Department of Breast Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yihua Wang
- Department of Breast Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Beige Zong
- Department of Breast Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Haochen Yu
- Department of Breast Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Feng Luo
- Department of Breast Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Shengchun Liu
- Department of Breast Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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The Role of Platelets in the Tumor-Microenvironment and the Drug Resistance of Cancer Cells. Cancers (Basel) 2019; 11:cancers11020240. [PMID: 30791448 PMCID: PMC6406993 DOI: 10.3390/cancers11020240] [Citation(s) in RCA: 84] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Revised: 01/29/2019] [Accepted: 02/15/2019] [Indexed: 02/06/2023] Open
Abstract
Besides the critical functions in hemostasis, thrombosis and the wounding process, platelets have been increasingly identified as active players in various processes in tumorigenesis, including angiogenesis and metastasis. Once activated, platelets can release bioactive contents such as lipids, microRNAs, and growth factors into the bloodstream, subsequently enhancing the platelet⁻cancer interaction and stimulating cancer metastasis and angiogenesis. The mechanisms of treatment failure of chemotherapeutic drugs have been investigated to be associated with platelets. Therefore, understanding how platelets contribute to the tumor microenvironment may potentially identify strategies to suppress cancer angiogenesis, metastasis, and drug resistance. Herein, we present a review of recent investigations on the role of platelets in the tumor-microenvironment including angiogenesis, and metastasis, as well as targeting platelets for cancer treatment, especially in drug resistance.
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Graziano V, Grassadonia A, Iezzi L, Vici P, Pizzuti L, Barba M, Quinzii A, Camplese A, Di Marino P, Peri M, Veschi S, Alberti S, Gamucci T, Di Gioacchino M, De Tursi M, Natoli C, Tinari N. Combination of peripheral neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio is predictive of pathological complete response after neoadjuvant chemotherapy in breast cancer patients. Breast 2019; 44:33-38. [PMID: 30611095 DOI: 10.1016/j.breast.2018.12.014] [Citation(s) in RCA: 100] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 12/26/2018] [Indexed: 12/23/2022] Open
Abstract
The immune system seems to play a fundamental role in breast cancer responsiveness to chemotherapy. We investigated two peripheral indicators of immunity/inflammation, i.e. neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR), in order to reveal a possible relationship with pathological complete response (pCR) in patients with early or locally advanced breast cancer treated with neoadjuvant chemotherapy (NACT). We retrospectively analyzed 373 consecutive patients affected by breast cancer and candidates to NACT. The complete blood cell count before starting NACT was evaluated to calculate NLR and PLR. ROC curve analysis determined threshold values of 2.42 and 104.47 as best cut-off values for NLR and PLR, respectively. The relationships between NLR/PLR and pCR, along with other clinical-pathological characteristics, were evaluated by Pearson's χ 2 or Fisher's exact test as appropriate. Univariate and multivariate analyses were performed using a logistic regression model. NLR and PLR were not significantly associated with pCR if analyzed separately. However, when combining NLR and PLR, patients with a NLRlow/PLRlow profile achieved a significantly higher rate of pCR compared to those with NLRhigh and/or PLRhigh (OR 2.29, 95% CI 1.22-4.27, p 0.009). Importantly, the predictive value of NLRlow/PLRlow was independent from common prognostic factors such as grading, Ki67, and molecular subtypes. The combination of NLR and PLR may reflect patients' immunogenic phenotype. Low levels of both NLR and PLR may thus indicate a status of immune system activation that may predict pCR in breast cancer patients treated with NACT.
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Affiliation(s)
- Vincenzo Graziano
- Department of Medical, Oral and Biotechnological Sciences and CeSI-MeT, G. D'Annunzio University, Chieti, Italy; Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, CB2 0RE, UK
| | - Antonino Grassadonia
- Department of Medical, Oral and Biotechnological Sciences and CeSI-MeT, G. D'Annunzio University, Chieti, Italy.
| | - Laura Iezzi
- Department of Medical, Oral and Biotechnological Sciences and CeSI-MeT, G. D'Annunzio University, Chieti, Italy
| | - Patrizia Vici
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Laura Pizzuti
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Maddalena Barba
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Alberto Quinzii
- Department of Medical, Oral and Biotechnological Sciences and CeSI-MeT, G. D'Annunzio University, Chieti, Italy
| | - Annarita Camplese
- Department of Medical, Oral and Biotechnological Sciences and CeSI-MeT, G. D'Annunzio University, Chieti, Italy
| | - Pietro Di Marino
- Department of Medical, Oral and Biotechnological Sciences and CeSI-MeT, G. D'Annunzio University, Chieti, Italy
| | - Marta Peri
- Department of Medical, Oral and Biotechnological Sciences and CeSI-MeT, G. D'Annunzio University, Chieti, Italy
| | - Serena Veschi
- Department of Pharmacy, G. D'Annunzio University, Chieti, Italy
| | - Saverio Alberti
- Medical Genetics, Department of Biomedical Science, University of Messina, Messina, Italy
| | | | - Mario Di Gioacchino
- Department of Medicine and Science of Ageing, G. D'Annunzio University, Chieti, Italy
| | - Michele De Tursi
- Department of Medical, Oral and Biotechnological Sciences and CeSI-MeT, G. D'Annunzio University, Chieti, Italy
| | - Clara Natoli
- Department of Medical, Oral and Biotechnological Sciences and CeSI-MeT, G. D'Annunzio University, Chieti, Italy
| | - Nicola Tinari
- Department of Medical, Oral and Biotechnological Sciences and CeSI-MeT, G. D'Annunzio University, Chieti, Italy
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Xue LB, Liu YH, Zhang B, Yang YF, Yang D, Zhang LW, Jin J, Li J. Prognostic role of high neutrophil-to-lymphocyte ratio in breast cancer patients receiving neoadjuvant chemotherapy: Meta-analysis. Medicine (Baltimore) 2019; 98:e13842. [PMID: 30608401 PMCID: PMC6344113 DOI: 10.1097/md.0000000000013842] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND We aimed to evaluate the correlation of neutrophil-to-lymphocyte ratio (NLR) with pathological response, disease-free survival (DFS), and overall survival (OS) in patients with breast cancer and under neoadjuvant chemotherapy (NAC). MATERIALS AND METHODS We performed a systematical search using Cochrane Library, ScienceDirect, PubMed, Embase, and Web of Science up to May 2018. On the basis of the data directly obtained from the available studies, the odds ratios (ORs) and their 95% confidence intervals (95% CIs) were pooled on the basis of higher or lower NLR levels. RESULTS The meta-analysis showed that high NLR was significantly associated with poor NAC response (OR = 2.27, 95% CI: 1.46-3.53, P < .001) but not with the DFS (OR = 1.18, 95% CI: 0.78-1.78, P = .435) and OS (OR = 2.781, 95% CI: 0.54-14.32, P = .221). CONCLUSION Although high NLR was significantly associated with poor pathological response, we were unable to demonstrate the prognostic value of NLR for DFS and OS in patients with breast cancer who were undergoing NAC.
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Affiliation(s)
| | | | | | - Yan Fang Yang
- Anesthesiology Department, Cangzhou Central Hospital
| | - Dong Yang
- General Surgery Department, Wuqiao People Hospital, Cangzhou
| | - Li Wei Zhang
- Laboratory Department, Yutian County Hospital, Tangshan, China
| | | | - Jie Li
- Thyroid and Breast Surgery
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28
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Cuello-López J, Fidalgo-Zapata A, López-Agudelo L, Vásquez-Trespalacios E. Platelet-to-lymphocyte ratio as a predictive factor of complete pathologic response to neoadjuvant chemotherapy in breast cancer. PLoS One 2018; 13:e0207224. [PMID: 30427884 PMCID: PMC6235359 DOI: 10.1371/journal.pone.0207224] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 10/27/2018] [Indexed: 01/07/2023] Open
Abstract
Response to neoadjuvant chemotherapy in breast cancer patients is of prognostic value in determining short- and mid-term outcomes. Inflammatory biomarkers, such as platelet-to-lymphocyte ratio (PLR) and neutrophil to lymphocyte ratio (NLR), have been proposed as predictive factors of response to neoadjuvant chemotherapy. Currently, there are no studies in Colombian patients reporting the role of inflammatory biomarkers as response predictors in patients receiving neoadjuvant chemotherapy. Therefore, in this study we performed a cross-sectional study and analyzed the association between inflammatory biomarkers and pCR (pathological complete response) in patients diagnosed with breast cancer–of different molecular subtypes- and treated with neoadjuvant chemotherapy. A total of 288 patients were included in the study, with a median age of 51 years old. Disease was locally advanced in 83% of the participants, and 77.7% had compromised lymph nodes. In our cohort, the most frequent tumor molecular subtype was luminal B/Her2- (27.8%) followed by triple negative [TN] (21.5%), luminal B/Her2+ (19.8%), Her2-enriched (16%) and luminal A (13.5%). PLR was not associated with age, menopausal status, baseline tumor size, histologic grade, axillary lymph node involvement, disease stage, estrogen receptor status, or Ki67; however, complete pathological response was significantly higher in the low PLR group (PLR<150) compared with the high PLR group (35.1% Vs. 22.2%, p = 0.03). In addition, Her2-enriched tumors achieved the highest pCR rates (65%), followed by TN (34%) tumors. Our results suggest that breast cancer patients with low platelet-to-lymphocyte ratio (PLR <150), treated with neoadjuvant chemotherapy achieve higher complete pathological response, independently of primary tumor molecular subtype.
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Affiliation(s)
- Javier Cuello-López
- Clinical Oncology Group, Fundación Colombiana de Cancerología-Clínica Vida, Medellín, Colombia
- * E-mail:
| | - Ana Fidalgo-Zapata
- Breast Surgeon Fellowship Program, School of Medicine, CES University, Medellín, Colombia
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Araki K, Ito Y, Fukada I, Kobayashi K, Miyagawa Y, Imamura M, Kira A, Takatsuka Y, Egawa C, Suwa H, Ohno S, Miyoshi Y. Predictive impact of absolute lymphocyte counts for progression-free survival in human epidermal growth factor receptor 2-positive advanced breast cancer treated with pertuzumab and trastuzumab plus eribulin or nab-paclitaxel. BMC Cancer 2018; 18:982. [PMID: 30326862 PMCID: PMC6191898 DOI: 10.1186/s12885-018-4888-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 10/02/2018] [Indexed: 01/04/2023] Open
Abstract
Background Although peripheral blood-based parameters (PBBPs) are reported as prognostic indicators in patients with breast cancers, their utility has not been studied in human epidermal growth factor receptor 2 (HER2)-positive advanced breast cancer (ABC). Tumor-infiltrating lymphocytes (TILs) might be a predictive factor in patients with HER2-positive ABC treated with pertuzumab and trastuzumab (PT) plus docetaxel. We aimed to evaluate whether PBBPs could have predictive value in HER2-positive ABC treated with pertuzumab and trastuzumab (PT) combined with eribulin (ERI) or nab-paclitaxel (Nab-PTX). Methods Data from 51 patients included in two single-arm, phase II trials were included in this retrospective-prospective study; the ERI + PT (N = 30) and Nab-PTX + PT (N = 21) combinations were registered under clinical trials number UMIN000012375 and UMIN000006838, respectively. We assessed PBBPs using prospectively collected data and investigated the association with progression-free survival (PFS); we evaluated absolute lymphocyte count (ALC), neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR). The cutoff values for ALC, NLR, and PLR were set at 1000 or 1500 cells/μL, 2, and 250, respectively. Results PFS was significantly improved in patients with ALC ≥1500/μL compared to those with ALC 1000–, <1500/μL or ALC < 1000/μL (P = 0.0106). High baseline ALC was significantly associated with improved PFS (≥1500/μL; hazard ratio [HR]: 0.3715; 95% confidence interval [CI]: 0.1735–0.7955; P = 0.0108). In contrast, improved PFS was not significantly associated with NLR or PLR. Improved PFS in patients with ALC ≥1500/μL was observed irrespective of visceral metastasis or chemotherapy regimen. Conclusions Our results showed that baseline ALC was a predictive factor for PFS in HER2-positive ABC treated with PT irrespective of combined chemotherapy regimen. Anti-tumor effects might be mediated not only by the tumor microenvironment, but also by systemic peripheral circulating lymphocytes. Baseline systemic parameters such as peripheral lymphocyte count might be beneficial in addition to disease extent for predicting the efficacy of PT treatment. Trial registration UMIN000012375, registration date: 21NOV2013, and UMIN000006838, registration date: 6DEC2011.
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Affiliation(s)
- Kazuhiro Araki
- Hyogo College of Medicine, Department of Surgery, Division of Breast and Endocrine Surgery, 1-1 Mukogawa, Nishinomiya, Hyogo, 663-8501, Japan.,The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Breast Medical Oncology, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Yoshinori Ito
- The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Breast Medical Oncology, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Ippei Fukada
- The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Breast Medical Oncology, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Kokoro Kobayashi
- The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Breast Medical Oncology, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Yoshimasa Miyagawa
- Hyogo College of Medicine, Department of Surgery, Division of Breast and Endocrine Surgery, 1-1 Mukogawa, Nishinomiya, Hyogo, 663-8501, Japan
| | - Michiko Imamura
- Hyogo College of Medicine, Department of Surgery, Division of Breast and Endocrine Surgery, 1-1 Mukogawa, Nishinomiya, Hyogo, 663-8501, Japan
| | - Ayako Kira
- Hyogo College of Medicine, Department of Surgery, Division of Breast and Endocrine Surgery, 1-1 Mukogawa, Nishinomiya, Hyogo, 663-8501, Japan
| | - Yuichi Takatsuka
- Hyogo College of Medicine, Department of Surgery, Division of Breast and Endocrine Surgery, 1-1 Mukogawa, Nishinomiya, Hyogo, 663-8501, Japan
| | - Chiyomi Egawa
- Kansai Rosai Hospital, Department of Surgery, 3-1-69 Inabaso, Amagasaki, Hyogo, 660-8511, Japan
| | - Hirofumi Suwa
- Hyogo Prefectural Amagasaki General Medical Center, Department of Breast Surgery, 2-17-77 East Namba-machi, Amagasaki, Hyogo, 660-8550, Japan
| | - Shinji Ohno
- The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Breast Medical Oncology, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Yasuo Miyoshi
- Hyogo College of Medicine, Department of Surgery, Division of Breast and Endocrine Surgery, 1-1 Mukogawa, Nishinomiya, Hyogo, 663-8501, Japan.
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Lee KH, Kim EY, Yun JS, Park YL, Do SI, Chae SW, Park CH. The prognostic and predictive value of tumor-infiltrating lymphocytes and hematologic parameters in patients with breast cancer. BMC Cancer 2018; 18:938. [PMID: 30285668 PMCID: PMC6167816 DOI: 10.1186/s12885-018-4832-5] [Citation(s) in RCA: 86] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 09/18/2018] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Carcinogenesis and tumor growth are associated with chronic inflammation and the host immune system. Here, we investigated the clinical significance and relationship between tumor-infiltrating lymphocytes (TILs) and hematologic parameters in patients with breast cancer. METHODS Invasive ductal breast cancer patients (N = 145) who underwent surgery were retrospectively evaluated. Samples were obtained using a core needle biopsy for CD8+, FOXP3+ TIL assessment. Blood lymphocytes, neutrophils, monocytes, and platelets were obtained by peripheral venous punctures. RESULTS CD8 + TILs were significantly associated with absolute lymphocyte count (ALC) and the absolute monocyte count (AMC). Low LMR (ALC/AMC) (cut-off - 5.3, range = 0.73-12.31) was associated with poor overall survival (OS) (p = 0.010), disease-free survival (DFS) (p = 0.005). However, in subgroup analysis, LMR did not have any value as a prognostic factor in HER2-positive breast cancers. TILs had different prognostic impacts across breast cancer subtypes, although they were not statistically significant. The treatment response after NAC tended to improve in breast cancer patients with high FOXP3+ TILs, low NLR (neutrophil count/ALC) (FOXP3 p for trend = 0.006, NLR p for trend = 0.063). CONCLUSIONS A relevance between TILs and hematologic parameters in breast cancer was demonstrated. The influence of the immune system on breast cancer progression may differ by subtype.
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Affiliation(s)
- Kwan Ho Lee
- Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul, 03181 South Korea
| | - Eun Young Kim
- Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul, 03181 South Korea
| | - Ji Sup Yun
- Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul, 03181 South Korea
| | - Yong Lai Park
- Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul, 03181 South Korea
| | - Sung-Im Do
- Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul, 03181 South Korea
| | - Seoung Wan Chae
- Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul, 03181 South Korea
| | - Chan Heun Park
- Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul, 03181 South Korea
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Li X, Dai D, Chen B, Tang H, Xie X, Wei W. The value of neutrophil-to-lymphocyte ratio for response and prognostic effect of neoadjuvant chemotherapy in solid tumors: A systematic review and meta-analysis. J Cancer 2018; 9:861-871. [PMID: 29581764 PMCID: PMC5868150 DOI: 10.7150/jca.23367] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 01/28/2018] [Indexed: 12/13/2022] Open
Abstract
Introduction: The neutrophil-to-lymphocyte ratio (NLR) has been found to be an indicator of poor prognosis in many tumour types. However, little is known about the relationship between the NLR and patients with tumours who receive neoadjuvant chemotherapy (NAC) in terms of response rate and prognostic ability. We thus performed this meta-analysis to further investigate this relationship. Methods: An electronic systematic literature search for articles published before September 2017 was performed to explore the association between the pretreatment NLR and outcome in patients treated with NAC. Data were extracted by the reported odds ratios (ORs) and hazard ratios (HRs) with their 95% confidence intervals (CIs) for the response rate and the survival outcome, respectively. The results were pooled using the random-effect or fixed-effect model. Results: Thirty-three studies were eventually included in our study, and all were published no earlier than 2011. An NLR that was higher than the cut-off was associated with a lower pathological complete response (pCR) rate in patients with cancer (OR = 1.72, 95% CI, 1.26-2.33). A lower NLR was associated with better overall survival (OS) (HR = 1.58, 95% CI, 1.34-1.86), cancer-specific survival (CSS) (HR = 2.22, 95% CI, 1.32-3.74), disease-free survival (DFS) (HR = 1.32, 95% CI, 1.10-1.59) and recurrence-free survival (RFS) (HR = 1.90, 95% CI, 1.50-2.40). Conclusion: Overall, an NLR lower than the cut-off value indicated a greater chance for pCR and may predict good survival outcomes after NAC for patients with solid tumours. The use of the NLR for risk stratification before NAC should be further demonstrated by future large-scale prospective studies.
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Affiliation(s)
| | | | | | | | - Xiaoming Xie
- Department of Breast Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 East Dong feng Road, Guangzhou, 510060, China
| | - Weidong Wei
- Department of Breast Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 East Dong feng Road, Guangzhou, 510060, China
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Chen G, Zhu L, Yang Y, Long Y, Li X, Wang Y. Prognostic Role of Neutrophil to Lymphocyte Ratio in Ovarian Cancer: A Meta-Analysis. Technol Cancer Res Treat 2018; 17:1533033818791500. [PMID: 30145940 PMCID: PMC6111397 DOI: 10.1177/1533033818791500] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 04/20/2018] [Accepted: 06/22/2018] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE The aim of the study was to investigate the prognostic role of neutrophil to lymphocyte ratio in ovarian cancer. Growing number of articles reported the relationship between neutrophil to lymphocyte ratio and prognosis in ovarian cancer, but the results remains inconclusive. The meta-analysis was conducted to analyze the association of pretreatment neutrophil to lymphocyte ratio with overall survival and progression-free survival. METHODS We performed a systematic literature research of PubMed, EMBASE, Medline, and Cochrane library for relevant studies up to October 8, 2017. The quality of included studies was assessed by the Newcastle-Ottawa Quality Assessment Scale. The hazard ratio and corresponding 95% confidence intervals were calculated. We checked the heterogeneity by the Q test and Higgins I-squared statistic. Begg funnel plot and Egger linear regression test were also applied for ascertain publication bias. All of the statistical analyses were performed using STATA version 12.0. RESULTS A total of 12 studies with 4046 patients were included in our study. The results indicated that depressed neutrophil to lymphocyte ratio was significantly correlated with higher overall survival (hazard ratio = 1.409, 95% confidence intervals = 1.112-1.786, P = .005) and progression-free survival (hazard ratio = 1.523, 95% confidence intervals = 1.187-1.955, P = .001) in ovarian cancer. Subgroup analysis by ethnicity of overall survival and progression-free survival showed that the prognostic effect of neutrophil to lymphocyte ratio was found both in Asians and Caucasians. CONCLUSION Patients with depressed neutrophil to lymphocyte ratio had a higher overall survival and progression-free survival in ovarian cancer. This meta-analysis provided neutrophil to lymphocyte ratio as an available predictor of overall survival and progression-free survival for patients with ovarian cancer.
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Affiliation(s)
- Gaowen Chen
- Department of Obstetrics and Gynecology, Zhujiang Hospital, Southern Medical
University, Guangzhou, Guangdong, China
| | - Lin Zhu
- Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong,
China
| | - Yulu Yang
- Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong,
China
| | - Yusheng Long
- Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong,
China
| | - Xiangyuan Li
- Department of Reproductive Medical Center, Women and Children Hospital of
Guangdong Province, Guangzhou, Guangdong, China
| | - Yifeng Wang
- Department of Obstetrics and Gynecology, Zhujiang Hospital, Southern Medical
University, Guangzhou, Guangdong, China
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Mouchemore KA, Anderson RL, Hamilton JA. Neutrophils, G-CSF and their contribution to breast cancer metastasis. FEBS J 2017; 285:665-679. [PMID: 28834401 DOI: 10.1111/febs.14206] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 08/03/2017] [Accepted: 08/18/2017] [Indexed: 12/15/2022]
Abstract
Evidence is mounting for a role for neutrophils in breast cancer progression to metastasis. However, the role of G-CSF in neutrophil biology in a cancer setting remains to be defined. Herein we discuss the most recent clinical and experimental evidence for neutrophils and G-CSF in the promotion of metastasis, demonstrating a potential mechanistic link between them. Understanding this link is imperative both for the development of diagnostic tests and for therapies targeting neutrophils to improve the treatment of breast cancer patients with or at risk of developing metastatic disease. As a high neutrophil-to-lymphocyte ratio in patients predicts poor outcome, while mild neutropenia predicts an improved outcome, we urge caution in the use of G-CSF in neutrophil recovery following chemotherapy as there is increasing evidence in preclinical models that G-CSF can promote metastasis.
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Affiliation(s)
- Kellie A Mouchemore
- Department of Biochemistry and Molecular Biology, Monash University, Clayton, Victoria, Australia.,Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia
| | - Robin L Anderson
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia.,Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria, Australia.,La Trobe University School of Cancer Medicine, Bundoora, Victoria, Australia
| | - John A Hamilton
- Arthritis and Inflammation Research Centre, Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
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