Breast cancer is the fourth leading cause of disability and death among all cancer types around the world. Cancer-associated inflammation is a key characteristic of tumor microenvironment which could be responsible for mechanism and pathogenesis of tumor aggregation and progression. In the present study, we sought to evaluate the prognostic value of Systemic Inflammation Response Index (SIRI) and Systemic Immune-Inflammation Index (SII) for a cohort of patients with locally advanced breast cancer receiving neoadjuvant chemotherapy (NACT).
Patients were included if they had confirmed diagnosis of locally advanced breast cancer by core needle biopsy. All patients underwent NACT prior to complete or partial excisional surgery of the breast tumor. The optimal cut-off values for inflammatory markers (i.e., SII, and SIRI) were evaluated by the receiver operating characteristic curve (ROC) analyses. The independent prognostic value of these indices was assessed by the cox proportional hazards regression model.
A total of 112 patients were included. The median follow-up time was 22 months. According to the ROC curve, the optimal cut-off value for SIRI and SII that predict disease-free survival (DFS) was 0.95 and 582 x 109/L, respectively. Higher SIRI and SII were associated with lower rate of pathologic complete response (pCR) (p<0.01) and higher rate of recurrence (p<0.01). In univariate analysis, the level of SIRI and SII negatively impacted DFS as follows: not reached vs 16.1 months (HR 14.83, 95%CI 3.26-67.44) and not reached vs 16.5 months (HR 20.08, 95%CI 2.62-53.78), respectively. No such effect was evident on overall survival (OS). HER2 status and platelet-lymphocyte ratio (PLR) were also independently correlated with DFS while none could significantly predict OS.
In this study, we established SIRI and SII as novel and easily accessible prognostic factors for cancer progression and response to therapy. These results can offer potential therapeutic benefit with cut-off values to be standardized further.
The authors.
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All authors have declared no conflicts of interest.