Tumour necrosis factor-alpha levels as predictor factor on clinical response of anthracycline-based neoadjuvant chemotherapy in locally advance breast cancer patients: experimental research.

Unlabelled: The prevalence of locally advanced breast cancer is increasing yearly, so biomarkers are needed to assist in its management, one of which is tumour necrosis factor-alpha (TNF-α).

Objective: Analysing TNF-α levels as a predictor factor on clinical response anthracycline-based neoadjuvant chemotherapy.

Methods: This study design used observational analysis. The length of study was carried out in the period from May 2021 to June 2022. The study procedure included measuring participants' TNF-α levels the day before chemotherapy was carried out and clinical response. Participants received anthracycline-based neoadjuvant chemotherapy (cyclophosphamide of 500 mg/m, doxorubicin of 50 mg/m and fluorouracil/5FU of 500 mg/m) for 3 cycles. The study analysis used the Chi-square, logistic regression and Spearman's test with <0.05.

Results: The average TNF-α levels was 137.2±311.8 pg/ml, ranging from 5.74 to 1.733 pg/ml. The results of the calculation of the cutoff value of TNF-α in the study were 18 635 pg/ml (area under curve =0.850; 95% CI =0.729-0.971). Based on cutoff 1, most participants with high TNF-α levels also had a negative response of 83.3% and those with low TNF-α levels also had a positive response of 75% (<0.001). Meanwhile, at cutoff 2, similar conditions were also found, namely high TNF-α levels, negative response (84.2%) and low TNF-α levels, positive response (78.9%; <0.001). The statical analysis showed a significant association of TNF-α levels on the clinical response of chemotherapy, which showed =-0.606 and <0.001.

Conclusion: TNF-α levels predict clinical response for anthracycline-based neoadjuvant chemotherapy in locally advanced breast cancer patients.