The relationship between the difference neutrophil to lymphocyte ratio before and after anthracycline-based neoadjuvant chemotherapy with clinical response in locally advanced breast cancer

Introduction: The difference in the Neutrophil-to-Lymphocyte Ratio (NLR) before and after chemotherapy, which is commonly called the delta NLR, is thought to be a better predictive factor than pre-chemotherapy NLR or post-chemotherapy NLR in breast cancer patients.Methods: We analyzed 130 locally advanced breast cancer (LABC) patients who received anthracycline-based neoadjuvant chemotherapy (NACT) at Dr. Soetomo General Hospital Surabaya from January 2017 - December 2021.Results: Out of 130 patients, 91 (70.0%) responded to chemotherapy. Bivariate analysis showed a significant relationship between delta NLR and chemotherapy response (p = 0.002). Patients with delta NLR < 0 achieved a significantly higher rate of clinical response to NACT compared to those with delta NLR >= 0 (OR: 4.67, 95% CI: 1.69 - 12.85, p: 0.003)Conclusion: LABC patients with delta NLR < 0 have better clinical response to anthracycline-based NACT than those with delta NLR >= 0.