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This systematic review and meta-analysis evaluated circulating systemic inflammatory response markers measured before starting neoadjuvant therapy. Electronic database searches identified eligible studies, and marker-specific meta-analyses were performed when at least three studies reported pCR rates, using odds ratios with 95% confidence intervals. Lower neutrophil-to-lymphocyte ratio, white cell count, and monocyte count correlated with higher pCR, with additional support from lymphocyte count.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/predictive-value-of-pretreatment-circulating-inflammatory-response-markers-in-the-neoadjuvant-treatment-of-breast-cancer-meta-analysis/341253/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/predictive-value-of-pretreatment-circulating-inflammatory-response-markers-in-the-neoadjuvant-treatment-of-breast-cancer-meta-analysis/341253.png","ImageObject",300,407,{"name":92,"@type":93},"Hazel","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-31","2026-09-22",true,{"@type":102,"interactionType":103,"userInteractionCount":52},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What question does the study address?","Question",{"text":112,"@type":113},"The study investigates whether pretreatment circulating systemic inflammatory response markers can predict response to neoadjuvant chemotherapy in breast cancer.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How were the meta-analyses performed for inflammatory markers?",{"text":117,"@type":113},"A systematic search identified studies measuring circulating inflammatory markers before neoadjuvant therapy. Meta-analysis was conducted for each marker when three or more studies reported pCR rates, summarizing outcomes as odds ratios with 95% confidence intervals.",{"name":119,"@type":110,"acceptedAnswer":120},"Which pretreatment marker patterns were associated with higher pCR rates?",{"text":121,"@type":113},"A lower pretreatment neutrophil-to-lymphocyte ratio, lower white cell count, and lower monocyte count were associated with higher pCR rates, while a higher lymphocyte count also correlated with increased pCR.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},341253,1790538862,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":52,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":52,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144},137441390410,"https://ap-avatar.wpscdn.com/avatar/2000252f4ab5702993?_k=1776741390130283984","BJS, 2024, znae132  \n[https://doi.org/10.1093/bjs/znae132](https://doi.org/10.1093/bjs/znae132)  \nSystematic Review  \nPredictive value of pretreatment circulating inflammatory response markers in the neoadjuvant treatment of breast cancer: meta-analysis  \nGavin P. Dowling1,2,3,* , Gordon R. Daly1,3, Aisling Hegarty1,3, Sandra Hembrecht1,3 , Aisling Bracken1, Sinead Toomey2, Bryan T. Hennessy2 and Arnold D. K. Hill1,3  \n1Department of Surgery, Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences, Dublin, Ireland  \n2Medical Oncology Lab, Department of Molecular Medicine, Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences, Dublin, Ireland  \n3Department of Surgery, Beaumont Hospital, Dublin, Ireland  \n*Correspondence to: Gavin P. Dowling, Department of Surgery, Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences, 123 St Stephen’s Green, Dublin 2, Ireland (e-mail: [gavindowling@rcsi.com](gavindowling@rcsi.com))  \nAbstract  \nBackground: Systemic inflammatory response markers have been found to have a prognostic role in several cancers, but their value in predicting the response to neoadjuvant chemotherapy in breast cancer is uncertain. A systematic review and meta-analysis of the literature was carried out to investigate this.  \nMethods: A systematic search of electronic databases was conducted to identify studies that explored the predictive value of circulating systemic inflammatory response markers in patients with breast cancer before commencing neoadjuvant therapy. A meta-analysis was undertaken for each inflammatory marker where three or more studies reported pCR rates in relation to the inflammatory marker. Outcome data are reported as ORs and 95% confidence intervals.  \nResults: A total of 49 studies were included, of which 42 were suitable for meta-analysis. A lower pretreatment neutrophil-tolymphocyte ratio was associated with an increased pCR rate (pooled OR 1.66 (95% c.i. 1.32 to 2.09); P \u003C 0.001) . A lower white cell count (OR 1.96 (95% c.i. 1.29 to 2.97); P = 0.002) and a lower monocyte count (OR 3.20 (95% c.i. 1.71 to 5.97); P \u003C 0.001) were also associated with a pCR. A higher lymphocyte count was associated with an increased pCR rate (OR 0.44 (95% c.i. 0.30 to 0.64); P \u003C 0.001) . Conclusion: The present study found the pretreatment neutrophil-to-lymphocyte ratio, white cell count, lymphocyte count, and monocyte count of value in the prediction of a pCR in the neoadjuvant treatment of breast cancer. Further research is required to determine their value in specific breast cancer subtypes and to establish optimal cut-off values, before their adoption in clinical practice.  \nIntroduction  \nThere is increasing evidence over the last few decades to support the use of neoadjuvant systemic therapy in the management of breast cancer. The benefits of neoadjuvant breast cancer treatment are well established, including the potential to down-stage disease and reduce the extent of breast and axillary surgery. Additional benefits include the potential to personalize adjuvant therapy options based on pathological response and to allow for assessment of tumour response to systemic therapy in vivo. A pCR is defined as the absence of residual invasive cancer in the resected breast specimen and all sampled regional lymph nodes after the completion of neoadjuvant systemic therapy (ypT0/Tis ypN0)1. Favourable long-term oncological outcomes have been associated with a pCR at surgery, particularly inpatients with triple-negative breast cancer (TNBC) and human epidermal growth factor receptor 2 (HER2)-positive tumours2 , 3. Therefore, it is necessary to identify a method to accurately predict which patients are likely to achieve a pCR and are thus optimal candidates for neoadjuvant systemic therapy.  \nIt is well understood that the host systemic inflammatory response plays a role in tumour development and progression4 , 5. Serum inflammat","cbCaigEKSbCQihnA","https://ap.wps.com/l/cbCaigEKSbCQihnA","pdf",242714,"English","# Abstract\n## Background\n## Methods\n## Results\n## Conclusion\n# Introduction\n# Methods","[{\"question\":\"What question does the study address?\",\"answer\":\"The study investigates whether pretreatment circulating systemic inflammatory response markers can predict response to neoadjuvant chemotherapy in breast cancer.\"},{\"question\":\"How were the meta-analyses performed for inflammatory markers?\",\"answer\":\"A systematic search identified studies measuring circulating inflammatory markers before neoadjuvant therapy. Meta-analysis was conducted for each marker when three or more studies reported pCR rates, summarizing outcomes as odds ratios with 95% confidence intervals.\"},{\"question\":\"Which pretreatment marker patterns were associated with higher pCR rates?\",\"answer\":\"A lower pretreatment neutrophil-to-lymphocyte ratio, lower white cell count, and lower monocyte count were associated with higher pCR rates, while a higher lymphocyte count also correlated with increased pCR.\"}]","Predictive value of pretreatment circulating inflammatory response markers in the neoadjuvant treatment of breast cancer: meta-analysis | PDF",1790041124,25]