Abstract P1-08-29: The influence of pre-treatment peripheral blood inflammatory markers on post-treatment response in patients with locally advanced breast cancer (LABC) from Saudi Arabia

Background: Inflammation is a recognized factor in cancer progression and resistance to treatment. Several studies correlated inflammation-related peripheral blood indices (PBI) to disease progression and poor survival in various cancers and different populations. Nonetheless, inflammation is affected by the distinctive characteristics and environmental exposure of each population. There is no prior study addressing the association of pre-treatment inflammatory markers with outcomes in patients with BC from Saudi Arabia. In this study, we evaluated post-treatment response of LABC in relation to inflammation-related PBI. Methods: We retrospectively analyzed the data of female patients with LABC undergoing neoadjuvant chemotherapy (NACT). Demographics, BMI, clinicopathologic characteristics and stage of the tumor, follow-up status and response to treatment were collected. Outcomes were evaluated in relation to pre-treatment PBI that were grouped based on the local laboratory cutoff values. Response rate (RR) and type was assessed according to post-NACT radiologic evaluation of the breast and subcategorized into complete response (CR), partial response (PR), stable disease (SD) and progressive disease (PD). Results: A total of 172 female patients with BC met the eligibility criteria from January 2014 to December 2019. The mean age at diagnosis was 53±11, and BMI was 31±6. Left BC accounted for 55% and the majority was invasive ductal carcinoma in 85.5%, moderately differentiated in 51%, stage III (AJCC 8th edition) in 73%, and HR-positive tumor in 79%. HER2-positive BC was reported in 32% and TNBC in 10%. Radiologic (CR) accounted for the majority of RR (71.5%). A higher percentage of patients with normal red cell distribution width (RDW) and low neutrophil to lymphocyte ratio (NLR) had radiologic CR with a significant P-value of (0.003) and (0.014), respectively (Table 1). Conclusion: Among several peripheral blood indices, only RDW and NLR significantly influenced post-treatment response in this cohort. They can be explored further to potentially predict response after systemic therapy in patients with LABC. The great advantage of these biomarkers stems from their availability and affordability in routine clinical practice.

Table 1.Post-treatment response type & distribution according to inflammation-related peripheral blood indicesVariablesCR(N=123)PR(N=20)SD(N=23)PD(N=6)P valueN=172N(%)N(%)N(%)N(%)NLR High >322(81%)2(7%)0(0%)3(11%)0.014Low ≤3101(70%)18(12%)23(15%)3(2%)RDW High >14.122(92%)2(8%)0(0%)0(0%)0.003Normal 11-14.1100(69%)18(12%)23(16%)5(3%)Low <111(50%)0(0%)0(0%)1(50%)

Citation Format: Atlal Abusanad, Abdullah M Alghamdi, Ahmed M Saggaf, Tala Gazzaz, Rival Brika. The influence of pre-treatment peripheral blood inflammatory markers on post-treatment response in patients with locally advanced breast cancer (LABC) from Saudi Arabia [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P1-08-29.

Comparison of pregnancy outcomes between women of advanced maternal age (≥35 years) versus younger women in a tertiary care center in Saudi Arabia

BACKGROUND

Pregnancy in women aged 35 years or above is generally considered an advanced maternal age (AMA). AMA is associated with an increased rate of maternal and neonatal complications.

OBJECTIVES

Assess the effect of AMA on maternal and neonatal outcomes.

DESIGN

Analytical cross-sectional study of medical records.

SETTINGS

In-patient hospital tertiary care setting in Jeddah.

PATIENTS AND METHODS

All women who attended antenatal care and delivered at King Abdulaziz Medical City in Jeddah in the first half of 2018 were included in the study. Outcomes for women 35 years of age or older were compared with younger women. Significant factors in a univariate analysis were entered in a multiple logistic regression model to assess the association between AMA and outcomes.

MAIN OUTCOME MEASURES

Rates of maternal neonatal complications, analysis of factors associated with advanced maternal, gestational diabetes mellitus (GDM), cesarean delivery.

SAMPLE SIZE

1586 women.

RESULTS

Of the 1586 women, 406 were 35 years of age or older (25.6%), and 1180 were younger than 35 years. The AMA group had a significantly higher proportion of GDM (32.0% versus 13.2%, P<.001). The adjusted odds ratio (OR) for GDM was 2.6 (95% CI 2-3.5, P<.001.) compared with younger women in the multivariate logistic regression analysis. Older women had a higher rate of cesarean delivery (43.6% versus 30.8%, P<.001). The adjusted OR for cesarean vs. vaginal delivery was 1.5 (CI 1.2-1.9, P=.002).

CONCLUSION

Pregnancy in women 35 years or older was associated with an increased risk of GDM and cesarean delivery.

LIMITATIONS

Cross-sectional design, small sample size, single hospital.

CONFLICT OF INTEREST

None.