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Oncotarget. 2018 Sep 14;9(72):33719-33733. doi: 10.18632/oncotarget.26120. eCollection 2018 Sep 14.

Predictive and prognostic role of peripheral blood eosinophil count in triple-negative and hormone receptor-negative/HER2-positive breast cancer patients undergoing neoadjuvant treatment.

Onesti CE1,2,3, Josse C1,2,3, Poncin A1,2,3, Frères P1,2,3, Poulet C1, Bours V1,4, Jerusalem G2,3.

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Laboratory of Human Genetics, GIGA Research Institute, University of Liège, Liège, Belgium.
Department of Medical Oncology, University Hospital (CHU Liège), Liège, Belgium.
Laboratory of Medical Oncology, GIGA Research Institute, University of Liège, Liège, Belgium.
Department of Human Genetics, University Hospital (CHU Liège), Liège, Belgium.


In current clinical practices, up to 27% of all breast cancer patients receive neoadjuvant chemotherapy. High pathological complete response rate is frequently associated with tumor-infiltrating lymphocytes. Additionally, circulating immune cells are also often linked to chemotherapy response. We performed a retrospective analysis on a cohort of 112 breast cancer patients (79 triple-negative, 33 hormone receptor-negative/HER2-positive) treated with standard neoadjuvant chemotherapy. Eosinophil and lymphocyte counts were collected from whole blood at baseline and during follow-ups and their associations with pathological complete response, relapse, disease-free and breast cancer-specific survival were analyzed. We observed a higher pathological complete response rate in patients who presented at baseline a relative eosinophil count ≥ 1.5% (55.6%) than in those with a relative eosinophil count < 1.5% (36.2%)(p = 0.04). An improvement in breast cancer-specific survival in patients with high relative eosinophil count (p = 0.05; HR = 0.336; 95% CI = 0.107-1.058) or with high relative lymphocyte count (threshold = 17.5%, p = 0.01; HR = 0.217; 95% CI = 0.060-0.783) were also observed. Upon combining the two parameters into the eosinophil x lymphocyte product with a threshold at 35.8, associations with pathological complete response (p = 0.002), relapse (p = 0.028), disease-free survival (p = 0.012) and breast cancer-specific survival (p = 0.001) were also recorded. In conclusion, the relative eosinophil count and eosinophil x lymphocyte product could be promising, affordable and accessible new biomarkers that are predictive for neoadjuvant chemotherapy response and prognostic for longer survival in triple-negative and hormone receptors-negative/HER2-positive breast cancers. Confirmation of these results in a larger patient population is needed.


HER2-positive breast cancer; eosinophil; neoadjuvant therapy; pathological complete response; triple-negative breast cancer

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