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Is insulin resistance a predictor for complete response in breast cancer patients who underwent neoadjuvant treatment?

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dc.contributor.authorDANE, FAYSAL
dc.contributor.authorsAlan, Ozkan; Akin Telli, Tugba; Aktas, Bilge; Koca, Sinan; Okten, Ilker Nihat; Hasanov, Rahib; Basoglu, Tugba; Arikan, Rukiye; Demircan, Nazim Can; Ercelep, Ozlem; Kaya, Serap; Ugurlu, Mustafa Umit; Kaya, Handan; Akgul Babacan, Nalan; Dane, Faysal; Yumuk, Perran Fulden
dc.date.accessioned2022-03-14T10:53:34Z
dc.date.available2022-03-14T10:53:34Z
dc.date.issued2020-12
dc.description.abstractPurpose Neoadjuvant chemotherapy is the standard front-line treatment modality in locally advanced breast cancer. Achieving pathological complete response (pCR) is a significant prognostic factor for prolonged disease-free and overall survival. Insulin resistance is defined as a pathological condition in which insulin effect is impaired in peripheral target tissues such as the skeletal muscle, liver, and adipose tissue. The relationship between breast cancer and insulin resistance is controversial. In this study, our aim is to evaluate the role of insulin resistance, body mass index (BMI), metabolic syndrome, and inflammation markers to predict complete response in breast cancer patients who underwent neoadjuvant treatment. Methods Data from 55 locally advanced non-diabetic breast cancer patients, treated with neoadjuvant chemotherapy between 2015 and 2017, were retrospectively evaluated. Homeostatic model assessment, IR = insulin resistance (HOMA-IR) was calculated by using the obtained insulin and fasting blood glucose values before neoadjuvant chemotherapy (fasting insulin x fasting glucose/405). We considered a cut-off of 2.5 for insulin resistance. The systemic inflammatory index (SII), neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) were calculated. Results Twenty-five patients had no insulin resistance. The most common pathologic subtype (56%) was hormone receptor (HR) positive and human epidermal growth factor receptor-2 (Her-2)-negative invasive ductal carcinoma. Sixteen (29%) patients had a pathological complete response (pCR). We found that the probability of pCR in patients with insulin resistance was 4.7 times lower than that in patients without insulin resistance [OR: 4.7 (95%CI 1.7-17.2),p= 0.01]. Conclusion Our results revealed that insulin resistance may have a negative effect on pathological complete response (pCR) following neoadjuvant therapy particularly with hormone-positive and Her-2-negative cases of non-diabetic breast cancer.
dc.identifier.doi10.1186/s12957-020-02019-y
dc.identifier.eissn1477-7819
dc.identifier.pubmed32907593
dc.identifier.urihttps://hdl.handle.net/11424/245338
dc.identifier.wosWOS:000571843500001
dc.language.isoeng
dc.publisherBMC
dc.relation.ispartofWORLD JOURNAL OF SURGICAL ONCOLOGY
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectBreast cancer
dc.subjectNeoadjuvant treatment
dc.subjectInsulin resistance
dc.subjectHOMA-IR
dc.subjectInflammation-based indices
dc.subjectPathological complete response
dc.subjectGROWTH-FACTOR-I
dc.subjectNECROSIS-FACTOR-ALPHA
dc.subjectBINDING PROTEIN-3
dc.subjectDIABETIC-PATIENTS
dc.subjectRISK
dc.subjectCHEMOTHERAPY
dc.subjectINFLAMMATION
dc.subjectEXPRESSION
dc.subjectMETFORMIN
dc.subjectMORTALITY
dc.titleIs insulin resistance a predictor for complete response in breast cancer patients who underwent neoadjuvant treatment?
dc.typearticle
dspace.entity.typePublication
local.avesis.idbea99c9b-dd23-43d2-8594-1b6fb3816a0f
local.import.packageSS16
local.indexed.atWOS
local.indexed.atSCOPUS
local.indexed.atPUBMED
local.journal.articlenumber242
local.journal.numberofpages9
local.journal.quartileQ2
oaire.citation.issue1
oaire.citation.titleWORLD JOURNAL OF SURGICAL ONCOLOGY
oaire.citation.volume18
relation.isAuthorOfPublication059ce50a-8d16-4fc6-a86c-85c9baa19a5c
relation.isAuthorOfPublication.latestForDiscovery059ce50a-8d16-4fc6-a86c-85c9baa19a5c

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