Tu207 - Differential Benefit and Safety of Neoadjuvant Chemotherapy in Patients with Breast Cancer According to Pretreatment Serum Prealbumin Levels

Yaohui Wang – Renji Hospital, School of Medicine, Shanghai Jiao Tong University; Yanping Lin – Renji Hospital, School of Medicine, Shanghai Jiao Tong University; Liheng Zhou – Renji Hospital, School of Medicine, Shanghai Jiao Tong University; Dan Tian – Beijing Friendship Hospital, Capital Medical University; Dong Zhang – Beijing Friendship Hospital, Capital Medical University; Zhongtao Zhang – Beijing Friendship Hospital, Capital Medical University; Wenjin Yin – Renji Hospital, School of Medicine, Shanghai Jiao Tong University; Jinsong Lu – Renji Hospital, School of Medicine, Shanghai Jiao Tong University

Abstract Text:

Background: Prealbumin is a sensitive and easy-to-access laboratory marker that reflects nutrition state, a crucial determinant of immune response that plays a vital role in the host defense against cancer. However, little evidence is reported on prealbumin and neoadjuvant chemotherapy (NAC) for breast cancer. We aimed to evaluate the relationships between prealbumin and treatment efficacy, survival outcomes, and safety in breast cancer receiving NAC.

Methods: Patients receiving cisplatin-paclitaxel-based NAC were included. Predictive value of prealbumin for pathological complete response (pCR) was evaluated by logistic regression analysis. Kaplan-Meier estimates were used to calculate survival rates, examined by log-rank test and Cox proportional hazards regression. Chi-squared test was performed to evaluate the association between adverse events and prealbumin.

Results: A total of 262 patients were included. Higher prealbumin levels were related to postmenopausal status (p=0.015) and higher body mass index (p=0.002). The pretreatment prealbumin levels could serve as an independent poor predictive factor for pCR (OR=0.487, 95% CI 0.243-0.974, p=0.042), with an interaction between prealbumin and hormone receptor in the postmenopausal patients (p=0.042). Besides, pretreatment prealbumin levels were also an independent poor prognostic factor for disease-free survival (adjusted HR=2.097, 95% CI 1.064-4.131, p=0.032). Furthermore, more hand-foot syndrome (p=0.003), rash (p=0.007), and insomnia (p=0.018) occurred in patients with lower prealbumin levels.

Conclusions: This study revealed that higher pretreatment serum prealbumin levels were a risk factor for chemosensitivity and prognosis but a protective factor for side effects in breast cancer receiving NAC. Prospective studies and basic research are warranted to elucidate its biomarker potential.