The Role of C-Reactive Protein as a Prognostic Biomarker in Patients with Early Breast Cancer Treated with Neoadjuvant Chemotherapy.

Background

C-reactive protein (CRP) is an acute phase reactant influenced by inflammation and tissue damage. Elevated CRP levels have been associated with poor outcome of various cancers including breast cancer. However, evidence regarding a potential impact of CRP levels on outcome of neoadjuvant chemotherapy (NACT) in patients with early breast cancer (EBC) is insufficient.

Methods

Patients who had received NACT for EBC and had available data regarding CRP levels before therapy, pathologic complete remission (pCR), and follow-up were included. The association between CRP at baseline and outcome parameters was analyzed.

Results

152 women were included in this analysis; median follow-up was 5.8 years. No association between CRP at baseline and pCR rates could be detected. 6.6% of the patients developed a local recurrence, 10.5% developed a distant recurrence, and 5.2% died from breast cancer. A negative correlation (Spearman-Rho) between CRP at baseline and overall survival (OS) (correlation coefficient (CC) -0.255;

Discussion/Conclusion

CRP at baseline is not predictive for pCR in EBC after NACT in our patient dataset. However, an association of parameters of long-term prognosis with CRP could be demonstrated. Although the correlations of higher CRP levels at baseline and shorter OS, DFS, LRFS, and DDFS were not significant, a strong trend could be detected that was reproduced in the analysis of different groups of CRP levels and the probability of breast cancer mortality. Higher CRP levels are indicating a worse prognosis in EBC after NACT in this retrospective analysis. These results justify further investigation of CRP not as a predictive parameter for pCR but as a biomarker of long-term prognosis in EBC in prospective trials and may lead to therapeutic approaches with the aim of lowering CRP levels.

Informations de copyright

Copyright © 2022 by S. Karger AG, Basel.

Déclaration de conflit d'intérêts

H.C.K. received honoraria and travel support from AstraZeneca, Pfizer, Roche, Daiichi Sankyo, Tesaro, MSD, onkowissen, Eli Lilly, SurgVision, Exact Sciences, und Genomic Health and holds stock of Theraclion und Phaon scientific. C.K.L. received honoraria from Roche, Novartis, Pfizer, Amgen, Astra Zeneca, onkowissen, Gilead Sciences, SeaGen, Sanofi-Genzyme, and MSD and research funding from Gilead Sciences. A.K.B. received honoraria and travel support from Amgen, AstraZeneca, Daiichi Sankyo, Hexal, Novartis, Pfizer, Roche, MSD, and SeaGen. O.H. received honoraria and travel support from Amgen, AstraZeneca, Daiichi Sankyo, Hexal, Novartis, Pfizer, Roche, MSD, Riemser, SeaGen, Gilead, and Eisai. A.E., S.W., M.S., and M.S. have nothing to disclose.