Blood-based
biomarkers reflect systemic
inflammation status and have prognostic and predictive value in solid
malignancies. As a recently defined
biomarker, Pan-Immune-
Inflammation-Value (PIV) integrates different peripheral blood cell subpopulations. This retrospective study of collected data aimed to assess whether PIV may predict the pathological complete response (pCR) to
neoadjuvant chemotherapy (NAC) in Turkish women with
breast cancer. The study consisted
of 743 patients with
breast cancer who were scheduled to undergo NAC before attempting
cytoreductive surgery. A pre-treatment complete blood count was obtained in the two weeks preceding NAC, and blood-based
biomarkers were calculated from absolute counts of relevant cell populations. The pCR was defined as the absence of
tumor cells in both the
mastectomy specimen and lymph nodes. Secondary outcome measures included disease-free survival (DFS) and overall survival (OS). One hundred seven patients (14.4%) had pCR. In receiver operating characteristic analysis, optimal cut-off values for the neutrophile-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte (PLR), PIV, and Ki-67 index were determined as ≥ 2.34, ≥ 0.22, ≥ 131.8, ≥ 306.4, and ≥ 27, respectively. The clinical
tumor (T) stage, NLR, MLR, PLR, PIV,
estrogen receptor (ER) status, human
epidermal growth factor receptor-2 (HER-2) status, and Ki-67 index were significantly associated with NAC response in univariate analyses. However, multivariate analysis revealed that the clinical T stage, PIV, ER status, HER-2 status, and Ki-67 index were independent predictors for pCR. Moreover, the low PIV group patients had significantly better DFS and OS than those in the high PIV group (p = 0.034, p = 0.028, respectively). Based on our results, pre-treatment PIV seems as a predictor for pCR and survival, outperforming NLR, MLR, PLR in predicting pCR in Turkish women with
breast cancer who received NAC. However, further studies are needed to confirm our findings.