Can pretreatment lactate dehydrogenase to albumin ratio predict pathological complete response after neoadjuvant chemotherapy in breast cancer patients?

BACKGROUND

This study aims to evaluate the predictive significance of platelet lymphocyte ratio (PLR), neutrophillymphocyte ratio (NLR), lymphocyte monocyte ratio (LMR), systemic immune-inflammation (SII), prognostic nutritional index (PNI), haemoglobin, albumin, lymphocyte, and platelet (HALP) score and lactate dehydrogenase to albumin ratio (LAR) for pCR in breast cancer with neoadjuvant chemotherapy (NACT).

METHODS

A total of 121 patients who received NACT between February 2012 and November 2021 were included. LAR, NLR, PLR, MLR, SII, PNI and HALP were calculated using formulas. The cut-off value for markers was obtained by Receiver operating characteristic curve (ROC) analyses. Independent predictive factors for pCR were determined using multivariate regression analysis.

RESULTS

The pCR rate was achieved in 31.4% of patients. Median values of NLR, PLR, MLR, SII, PNI and HALP were similar in pCR (+) and pCR (-) (p>0.05). The median LAR value was significantly higher in pCR (+) than in pCR (-) (50.80 vs 42.62, respectively (p=0.002)). The optimal cut-off value of LAR was 46.27. Multivariate analysis showed that LAR ≥46.27 and HER-2 positivity were the independent predictive factors for pCR [OR=2.851 (95% CI=1.142-7.119, P=0.025), OR=3.431 (95% CI= 0.163-10.123, P=0.026), respectively].

CONCLUSIONS

LAR is a simple, inexpensive, and convenient method for predicting pCR in breast cancer with NACT.