Key result
High pre-treatment neutrophil-to-lymphocyte ratio linked to ~9-fold greater CTRCD risk in anthracycline-treated breast cancer patients.
Why the study?
Anthracycline-induced cardiac dysfunction is a major concern after therapy, motivating the identification of clinical characteristics in patients at high risk of developing CTRCD.
Do high neutrophil-to-lymphocyte ratio, advanced cancer stage, and doxorubicin increase the risk of cancer therapy-related cardiac dysfunction in breast cancer patients treated with anthracyclines?
Cohort (n=177)
No
Do high neutrophil-to-lymphocyte ratio, advanced cancer stage, and doxorubicin increase the risk of cancer therapy-related cardiac dysfunction in breast cancer patients treated with anthracyclines?
Advanced cancer stage, elevated neutrophil-to-lymphocyte ratio, and doxorubicin use are significant risk factors for developing cancer therapy-related cardiac dysfunction in breast cancer patients.
Answers are grounded in this paper and cite their sources.
Elevated pre-treatment NLR was associated with higher CTRCD risk in anthracycline-treated breast cancer; hypothesis-generating for NLR-based stratification pending prospective validation.
PURPOSE: Cardiac dysfunction as a result of anthracycline treatment is a major concern regarding the management of patient life after therapy. The aim of the present study was to determine the clinical characteristics of cancer patients at high risk of developing cancer therapy-related cardiac dysfunction (CTRCD), in order to improve the risk management for the appropriate treatment. METHODS: This is a single-center, retrospective study of patients with breast cancer who underwent anthracycline treatment and had regular consultations with cardiologists. To investigate the incidence of CTRCD and the risk factors related to its occurrence, left ventricular ejection fraction (LVEF), cardiac troponin I (TnI), and brain natriuretic peptide (BNP) were assessed in 177 patients at the start of anthracycline treatment, and again at 3, 6, 9, and 12 months. RESULTS: Eight patients (4.5%) developed CTRCD (CTRCD group). The comparisons between the CTRCD group and those without CTRCD (non-CTRCD group) showed significant differences in pre-treatment cancer stage and neutrophil/lymphocyte ratio (NLR). Multivariate analysis showed a strong association between pre-treatment cancer stage, NLR, and type of anthracycline administered (epirubicin or doxorubicin). CONCLUSION: High NLR, the more advanced stages of cancer, and doxorubicin administration were suggested as possible risk factors for the development of CTRCD. Special attention should be warranted for patients with any of these risk factors.
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Kuroda et al. (2024) conducted a cohort in Breast cancer (n=177). High neutrophil/lymphocyte ratio (NLR ≥ 3.0) vs. NLR < 3.0 was evaluated on Development of cancer therapy-related cardiac dysfunction (CTRCD) (OR 9.02, 95% CI 1.40-58.13, p=0.02). A high pre-treatment neutrophil-to-lymphocyte ratio (≥3.0) was significantly associated with an increased risk of developing cancer therapy-related cardiac dysfunction (OR 9.02) in breast cancer patients receiving anthracyclines.
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