ArticleBreast cancer (Tokyo, Japan)2026
The value of LAR in predicting neoadjuvant therapy response and prognosis in HER2-positive breast cancer.
Article in Breast cancer (Tokyo, Japan), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundIn the personalized treatment of HER2-positive breast cancer, identifying biomarkers predictive of neoadjuvant therapy (NAT) response and long-term prognosis is crucial. This study investigates the association between the lactate dehydrogenase-to-albumin ratio (LAR) and both NAT efficacy and survival outcomes, while examining clinical-pathological factors influencing LAR. MATERIALS AND
methodsThis retrospective study analyzed clinical and pathological data from 302 HER2-positive breast cancer patients who underwent NAT followed by surgical resection. Patients were stratified into two groups based on median pre-NAT LAR levels. Logistic regression identified independent predictors of NAT response. Kaplan-Meier survival analysis and Cox proportional hazards regression evaluated correlations between LAR and disease-free survival (DFS) or overall survival (OS). Univariate and multivariate analyses determined clinical and pathological factors influencing LAR.
resultsLogistic regression analysis identified LAR levels, hormone receptor status, and pre-NAT tumor size as independent predictors of NAT response. Patients in the high-LAR group exhibited a higher probability of achieving pathological complete response (pCR) following neoadjuvant therapy. Cox regression and Kaplan-Meier analyses demonstrated significantly shorter disease-free survival (DFS) in the high-LAR cohort compared to the low-LAR group. Furthermore, among patients who experienced disease progression, high pre-NAT LAR was significantly associated with early recurrence (≤ 24 months) (P = 0.005). Crucially, subgroup and interaction analyses revealed that the predictive and prognostic value of LAR was more pronounced in the hormone receptor (HR)-negative subgroup (P for interaction = 0.043). Among clinical and pathological factors, LAR levels correlated significantly with hormone receptor-negative status and postmenopausal condition.
conclusionIn HER2-positive breast cancer, elevated pre-NAT LAR serves as an independent predictor for pCR after NAT, while concurrently constituting an independent risk factor for reduced DFS. This dual effect is particularly pronounced in HR-negative patients. Furthermore, HR-negative status and postmenopausal condition were significantly associated with higher LAR levels, highlighting LAR as a potential indicator of a hostile host systemic environment.
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