Is insulin resistance a predictor for complete response in breast cancer patients who underwent neoadjuvant treatment?
Breast cancer
HOMA-IR
Inflammation-based indices
Insulin resistance
Neoadjuvant treatment
Pathological complete response
Journal
World journal of surgical oncology
ISSN: 1477-7819
Titre abrégé: World J Surg Oncol
Pays: England
ID NLM: 101170544
Informations de publication
Date de publication:
09 Sep 2020
09 Sep 2020
Historique:
received:
20
05
2020
accepted:
01
09
2020
entrez:
10
9
2020
pubmed:
11
9
2020
medline:
15
5
2021
Statut:
epublish
Résumé
Neoadjuvant chemotherapy is the standard front-line treatment modality in locally advanced breast cancer. Achieving pathological complete response (pCR) is a significant prognostic factor for prolonged disease-free and overall survival. Insulin resistance is defined as a pathological condition in which insulin effect is impaired in peripheral target tissues such as the skeletal muscle, liver, and adipose tissue. The relationship between breast cancer and insulin resistance is controversial. In this study, our aim is to evaluate the role of insulin resistance, body mass index (BMI), metabolic syndrome, and inflammation markers to predict complete response in breast cancer patients who underwent neoadjuvant treatment. Data from 55 locally advanced non-diabetic breast cancer patients, treated with neoadjuvant chemotherapy between 2015 and 2017, were retrospectively evaluated. Homeostatic model assessment, IR = insulin resistance (HOMA-IR) was calculated by using the obtained insulin and fasting blood glucose values before neoadjuvant chemotherapy (fasting insulin × fasting glucose/405). We considered a cut-off of 2.5 for insulin resistance. The systemic inflammatory index (SII), neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) were calculated. Twenty-five patients had no insulin resistance. The most common pathologic subtype (56%) was hormone receptor (HR) positive and human epidermal growth factor receptor-2 (Her-2)-negative invasive ductal carcinoma. Sixteen (29%) patients had a pathological complete response (pCR). We found that the probability of pCR in patients with insulin resistance was 4.7 times lower than that in patients without insulin resistance [OR: 4.7 (95%CI 1.7-17.2), p = 0.01]. Our results revealed that insulin resistance may have a negative effect on pathological complete response (pCR) following neoadjuvant therapy particularly with hormone-positive and Her-2-negative cases of non-diabetic breast cancer.
Identifiants
pubmed: 32907593
doi: 10.1186/s12957-020-02019-y
pii: 10.1186/s12957-020-02019-y
pmc: PMC7488234
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
242Références
Cancer Prev Res (Phila). 2010 Nov;3(11):1451-61
pubmed: 20947488
Lancet. 1999 May 15;353(9165):1649-52
pubmed: 10335783
Diabetes Care. 2003 Dec;26(12):3320-5
pubmed: 14633821
Exp Diabetes Res. 2012;2012:789174
pubmed: 22701472
Medicine (Baltimore). 2019 Jan;98(1):e13842
pubmed: 30608401
Oncogene. 2018 Apr;37(15):2022-2036
pubmed: 29367764
Lancet. 2014 Jul 12;384(9938):164-72
pubmed: 24529560
Circulation. 2005 Oct 25;112(17):2735-52
pubmed: 16157765
Asian Pac J Cancer Prev. 2019 Jul 01;20(7):2209-2212
pubmed: 31350986
Diabetes. 2001 Oct;50(10):2384-9
pubmed: 11574423
J Am Coll Surg. 1995 Mar;180(3):297-306
pubmed: 7874340
Onco Targets Ther. 2019 May 21;12:3977-3989
pubmed: 31190894
J Clin Endocrinol Metab. 2002 Oct;87(10):4602-6
pubmed: 12364441
FEBS Lett. 2008 Jan 9;582(1):97-105
pubmed: 18053812
Appl Immunohistochem Mol Morphol. 2011 May;19(3):218-25
pubmed: 21217522
Cancer Lett. 2003 Jun 10;195(2):127-37
pubmed: 12767520
Turk J Med Sci. 2019 Feb 11;49(1):245-248
pubmed: 30761879
J Natl Cancer Inst. 2009 Jan 7;101(1):48-60
pubmed: 19116382
J Clin Oncol. 2012 May 20;30(15):1796-804
pubmed: 22508812
Breast Cancer Res Treat. 2012 Feb;132(1):131-42
pubmed: 21574055
Cancer Epidemiol Biomarkers Prev. 2008 Apr;17(4):921-9
pubmed: 18398032
Int J Cancer. 2013 Mar 1;132(5):1191-200
pubmed: 22847383
Lancet Oncol. 2018 Jan;19(1):27-39
pubmed: 29242041
Endocr Relat Cancer. 2012 Nov 09;19(6):R225-41
pubmed: 22936542
BMC Cancer. 2015 Dec 29;15:1027
pubmed: 26715527
CA Cancer J Clin. 2019 Jan;69(1):7-34
pubmed: 30620402
Clin Endocrinol (Oxf). 2014 Oct;81(4):536-41
pubmed: 24372524
Diabetes Obes Metab. 2012 Dec;14(12):1073-80
pubmed: 22537210
J Clin Invest. 1995 May;95(5):2409-15
pubmed: 7738205
Clin Breast Cancer. 2015 Jun;15(3):204-11
pubmed: 25600243
J Clin Oncol. 2009 Jul 10;27(20):3297-302
pubmed: 19487376
Arch Physiol Biochem. 2008 Feb;114(1):63-70
pubmed: 18465360
Lancet Oncol. 2012 Jan;13(1):25-32
pubmed: 22153890
Indian J Pathol Microbiol. 2012 Oct-Dec;55(4):481-4
pubmed: 23455784
Lancet. 2004 Apr 24;363(9418):1346-53
pubmed: 15110491
BMJ. 2012 Apr 26;344:e2718
pubmed: 22539013
J Clin Invest. 2006 Jul;116(7):1793-801
pubmed: 16823477
Oncologist. 2016 Sep;21(9):1041-9
pubmed: 27388232
Breast Cancer Res. 2015 Mar 03;17:32
pubmed: 25849721
J Natl Cancer Inst. 2004 Apr 7;96(7):546-53
pubmed: 15069117
J Natl Cancer Inst Monogr. 2001;(30):96-102
pubmed: 11773300
Curr Diab Rep. 2010 Apr;10(2):93-100
pubmed: 20425567
Genes Dis. 2015 Mar 1;2(1):13-25
pubmed: 25984556
J Natl Cancer Inst. 2005 Feb 2;97(3):188-94
pubmed: 15687361
Diabetes. 1988 Dec;37(12):1595-607
pubmed: 3056758
J Clin Oncol. 2008 Feb 10;26(5):778-85
pubmed: 18258986
J Clin Oncol. 2002 Jan 1;20(1):42-51
pubmed: 11773152
Cytokine Growth Factor Rev. 2005 Aug-Oct;16(4-5):407-20
pubmed: 15886048
Diabetes Metab Res Rev. 2010 Nov;26(8):599-601
pubmed: 20941806