Background and Objectives: Neoadjuvant chemotherapy (NAC) improves survival by increasing pathologic complete response (pCR). Blood-based indexes have been studied in breast cancer for predicting pCR and prognosis, but the results are conflicting. We aimed to assess the impact of inflammatory and nutritional indexes on pCR and survival. Materials and Methods: We retrospectively analyzed 304 patients. Pre-NAC laboratory data were used to calculate their neutrophil-to-lymphocyte ratios (NLR), pan-immune inflammation values (PIV), lactate dehydrogenase–albumin ratios (LAR), and prognostic nutritional indexes. The optimal cut-off values were determined through an analysis of the receiver operating characteristic curve. Survival analyses were performed using the Kaplan–Meier method. Multivariate regression analyses were performed to reveal the factors predicting pCR. Univariate and multivariate survival analyses were conducted to identify prognostic factors predicting survival. Results: The median follow-up was 38.5 months. pCR was achieved in 41.4% of the patients. In the univariate analyses, the NLR (p = 0.032) and PIV (p = 0.002) were indexes associated with pCR. In the multivariate analysis, the PIV (p = 0.008) was the only index significantly correlated with pCR. According to the multivariate Cox regression analyses, clinical stage 3 (p = 0.032), a pathologic response other than pCR (p = 0.021), and a high LAR (≥4.72) (p = 0.002) were correlated with increased recurrence risk. The univariate Cox regression analyses revealed that failure to achieve pCR (p = 0.037) and the presence of a high LAR (p = 0.044) were significant predictors of overall survival. However, the multivariate analyses failed to identify any significant predictors of death. Conclusions: We found that the PIV was more effective than the other indexes in predicting pCR. To our knowledge, this study is the first to determine an association between the LAR and disease-free survival in patients with breast cancer receiving NAC. We concluded that a high LAR was a poor prognostic factor, especially in patients without a pCR. Therefore, close postoperative monitoring and the intensification of adjuvant treatment should be considered for these patients. However, further studies are needed to confirm our findings.

Prognostic Significance of Neutrophil-to-Lymphocyte Ratio in Predicting Complete Pathological Response in Rectal Cancer Patients Receiving Neoadjuvant Chemoradiotherapy - Article abstract #943750

Sarcopenia's Role in Neoadjuvant Chemotherapy Outcomes for Locally Advanced Breast Cancer: A Retrospective Analysis - Article abstract #945240

Background: Leukocytoclastic vasculitis (LCV) is a vasculitic inflammation against blood vessels. Various anticancer therapies can cause vasculitis, but capecitabine-induced LCV is an unusual entity. Here, we describe an LCV case associated with neoadjuvant capecitabine use for locally advanced rectal cancer (LARC). Case report: A 70-year-old man presented with rectal bleeding. A colonoscopic biopsy revealed rectal adenocarcinoma and he was diagnosed with LARC after imaging studies. Capecitabine plus radiation therapy was started as a neoadjuvant treatment. Management and outcome: Seven days after the first capecitabine dose, the patient was admitted with a rash. The LCV diagnosis was histopathologically proven. Capecitabine was withheld. After the patient's rash began to regress under corticosteroid pressure, capecitabine was started at a lower dose. His treatment was completed successfully with oral corticosteroids plus low-dose capecitabine. Discussion: We aimed to point out a rare and unusual adverse effect of a frequently used drug in oncologic practice.

The aim of this study is to evaluate the prognostic value of molecular profiling in patients with metastatic non-small-cell lung cancer (NSCLC). This single-center study included patients diagnosed and treated between July 2020 and April 2024. The molecular profiles of patients detected by either next-generation sequencing or conventional methods were reviewed retrospectively. Survival analyses were conducted based on the targetable alterations and treatments received. Seventy patients were included, with a median age of 65 years and a median overall survival (OS) of 13 months. Of all patients, 56 (80%) had at least one molecular alteration, and the most frequent alteration was TP53 (52.9%), followed by KRAS (20%) and EGFR (8.6%). Eighteen patients (25.7%) had an alteration amenable to targeted therapy. Patients who could reach a matched targeted therapy at any treatment line exhibited a longer median OS compared to those who could not (not reached vs. 6.9 months, p = 0.042). Patients with a targetable alteration for first-line treatment demonstrated a longer progression-free survival compared to those without a targetable alteration (not reached vs. 4.9 months, p = 0.006). According to current guidelines, conducting molecular testing to identify all potential targetable alterations in NSCLC is the cornerstone of the treatment decision process. The survival analysis in this study emphasized the impact of the use of targeted therapies on the survival outcomes.

Objective: Even in stage I lung cancer, the heightened risk of recurrence may lead to diminished survival rates. Only a few reports on prognostic factors have been published for stage I disease using the most recent staging system. This study was designed to identify predictive factors of recurrence and survival in early-stage lung cancer (LC) staged according to the eighth edition of the Tumor, Node, Metastasis (TNM) classification. Materials and Methods: The clinicopathological characteristics, treatment, and follow-up data of 100 stage I patients monitored between 2013 and 2023 were retrospectively reviewed. The association between clinicopathological factors and survival was analyzed to identify prognostic factors. Results: The median age was 61 years (range, 35–76). All patients had a histologic diagnosis of non-small cell lung cancer, with 62% being adenocarcinoma. During a median follow-up of 40.3 months (range, 1–183.5), 20 patients experienced recurrence and 16 died. The two-year and five-year disease-free survival (DFS) rates were 81% and 73%, respectively, while overall survival (OS) rates for the same periods were 86% and 77%. Multivariate analysis revealed that a smoking history greater than 40 pack-years (p=0.021) and perineural invasion (PNI) (p=0.049) were predictors of recurrence, while the presence of lymphovascular invasion (LVI) was significantly associated with OS (p=0.019). Conclusion: Smoking significantly increases the risk of LC development and recurrence, making it crucial to promote smoking cessation. Patients with positive LVI or PNI in early-stage LC should be monitored more closely, although further research is warranted.