To Study the Neutrophil Lymphocyte Ratio As a Predictive Marker of Response to Neoadjuvant Chemotherapy in Locally Advanced Triple-Negative Breast Cancer

Abstract

Introduction Triple-negative breast cancer (TNBC) is the most aggressive form of invasive breast cancer. A key predictor of positive outcomes is achieving a pathological complete response (pCR) following neoadjuvant chemotherapy (NACT). This study aims to evaluate the role of pre-chemotherapy neutrophil-to-lymphocyte ratio (NLR) as a predictive marker of pCR. Objective The aim of the study is to study the pCR rate after NACT in relation to NLR in patients with locally advanced TNBC. Materials and Methods This prospective study enrolled 120 consecutive female patients with locally advanced TNBC who were planned for NACT at the Kidwai Memorial Institute of Oncology from July 2022 to July 2024. Peripheral blood samples were collected before treatment to calculate NLR. The predictive value of NLR for pCR was assessed using descriptive statistics, Chi-square tests, and receiver operating characteristic (ROC) curve analysis. Results The final analysis included 101 patients. Thirty-one patients (30.7%) achieved pCR. Patients with pCR had a significantly lower mean NLR (2.29 ± 1.21) than the non-pCR group (2.85 ± 1.34). The optimal NLR cut-off for predicting pCR was 2.18. Low NLR (≤2.18) was significantly associated with higher pCR rates (67.74 vs. 32.25% for high NLR, p <0.05). Conclusion Pre-chemotherapy NLR is a potential predictive marker for pCR in locally advanced TNBC. Patients with a lower NLR were more likely to achieve pCR, suggesting its potential utility in risk stratification.