Abstract P3-11-09: Elevated peripheral blood lymphocyte-to-monocyte ratio predicts favorable response and prognosis in locally advanced breast cancer after neoadjuvant chemotherapy

Neoadjuvant chemotherapy (NAC) is the standard of care for locally advanced breast cancer (LABC). However, the lack of efficient method to predict the treatment response and prognosis limits the clinical evaluation of the patient eligibility. Elevated lymphocyte-to-monocyte ratio (LMR) has been reported to be associated with favorable prognosis in some hematology malignancies and nasopharyngeal carcinoma, but has not been studied in breast cancer. The purpose of this study is to evaluate whether the LMR is a predictor of the curative impact of LABC patients after NAC and short/long-term mortality. A retrospective cohort of 542 LABC patients who received NAC was recruited between May 2002 and August 2011. The counts for peripheral absolute lymphocyte and monocyte before NAC were retrieved, and the LMR was calculated. Receiver operating characteristic curve analysis, univariate and multivariate Cox proportional hazards analyses were applied to evaluate the associations of LMR with overall survival (OS) and disease-free survival (DFS) respectively. Univariate analysis revealed that higher LMR level (≥4.25) was significantly related to better overall response rate (P = 0.005). Univariate analysis revealed that higher LMR level (≥4.25) was significantly associated with superior OS (P = 0.014), DFS (P = 0.009). The higher lymphocyte count (≥1.5×10 9 /L) was significantly associated with better OS (P = 0.035), while the lower monocyte count ( 9 /L) was associated with better OS (P = 0.007) and DFS (P = 0.01), respectively. Multivariate Cox proportional hazard analysis showed that higher LMR level was a significantly independent predictor for superior OS (hazard ratio or HR = 0.636, 95% confidence interval or 95% CI = 0.432-0.937; P = 0.022), DFS (HR = 0.666, 95% CI = 0.495-0.896; P = 0.007) respectively. The traditional predictive factors, including tumor size, lymph node status, hormone receptor status and HER2 status, were also independent prognostic factors of OS and DFS. The elevated pre-NAC peripheral LMR level was a significant favorable factor for NAC LABC prognosis and this easily accessed variable may serve as a potent marker to predict the outcomes of LABC patients after NAC. Citation Format: Lei Wang, Xiao-Jian Ni, Guo-Wei Qian, Qian-Wen Ou-Yang, Xiao-Lan Zhang, Yi-Zhou Jiang, Sheng Chen, Xin Hu, Zhi-Ming Shao. Elevated peripheral blood lymphocyte-to-monocyte ratio predicts favorable response and prognosis in locally advanced breast cancer after neoadjuvant chemotherapy [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P3-11-09.