Page 143 - SRPSKO DRUŠTVO ISTRAŽIVAČA RAKA

SDIRSACR Oncology Insights

Background: Chronic inflammation is known to promote breast cancer progression and may modulate the effectiveness
of endocrine therapies, including aromatase inhibitors (AIs). Cytokines, central to immune regulation and tumor
microenvironment signaling, represent potential targets for intervention. Nutritional strategies aimed at reducing
systemic inflammation may beneficially influence cytokine profiles and patient outcomes during AI therapy.
Patients and Methods: We conducted a 4-month randomized controlled trial involving 30 postmenopausal women with
stage I–IIIa breast cancer undergoing adjuvant AI therapy for at least 6 months. Participants were randomized into two
matched groups. The intervention group (n=16, mean age: 58.2±6.7 years) adhered to a structured anti-inflammatory
diet enriched in omega-3 fatty acids, fiber, and antioxidants, and low in refined carbohydrates and saturated fats. The
control group (n=14, mean age: 58.4±7.5 years) maintained their usual diet. Plasma cytokine levels were assessed at
baseline and after 4 months via flow cytometry.
Results: After 4 months, the intervention group demonstrated significant reductions in circulating cytokines relative to
controls: IL-18 (↓32%, p<0.001), IL-33 (↓9%, p<0.01), IFN-γ (↓28%, p<;0.05), and IFN-α2 (↓33%, p<0.01). Additional
significant decreases were observed in TNF-α (↓39%), IL-6 (↓41%), IL-10 (↓41%), and IL-17A (↓49%) (p<0.05 for all).
Furthermore, the intervention group experienced reductions in body mass index (BMI, −8.83%) and visceral fat area
(−20.5%). No significant changes were detected in the control group.
Conclusions: An anti-inflammatory diet significantly reduced proinflammatory and interferon cytokines in breast
cancer patients on AI therapy, accompanied by decreases in BMI and visceral adiposity. These results suggest that
dietary modulation can mitigate systemic inflammation and potentially improve immune homeostasis during endocrine
treatment. Further studies involving a larger number of patients are warranted to explore long-term clinical benefits
and underlying mechanisms.

Acknowledgments and funding: This study was supported by the Science Fund of the Republic of Serbia (Grant PRISMA
No.5050, Project title: Anti-Inflammatory Dietary intervention in breast cancer patients receiving aromatase inhibitors-
AID).

P49

Predictive value of inflammatory ratios on the outcome of advanced melanoma patients treated with
anti-PD1 monotherapy: A multicentric analysis

Aleksandar Popović *, Branko Dujovic *, Philipp Schnecko , Ana Stojković ,Ivana Jocic , Emir Sokolović , Ivan
2
1
4
3
2
1
Petković , Amina Jalovčić Suljević , Lidija Kandolf 2
1,5
4
1Clinic of Oncology, University Clinical Center Niš, Niš, Serbia
2Clinic of Dermatovenerology, Military Medical Academy, Belgrade, Serbia
3Alcedis GmbH, Gießen, Hessen, Germany
4Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
5Department for Oncology, Faculty of Medicine, University of Niš, Niš, Serbia
Keywords: melanoma, immune-checkpoint inhibitors, inflammation, outcome

Background: Despite immune-checkpoint inhibitors (ICIs) transforming outcomes of melanoma patients, a vast number
remain unresponsive to treatment. Baseline-derived host-related inflammatory ratios such as neutrophil-lymphocyte
ratio (NLR), platelet-lymphocyte ratio (PLR) and monocyte-lymphocyte ratio (MLR) are easily accessible biomarkers
that can depict the balance between myeloid-derived protumour inflammation and lymphocyte-derived antitumour
response. Our analysis aims to assess the predictive value of baseline inflammatory ratios on the outcome of melanoma
patients treated with mono-ICIs.
Patients and Methods: We conducted a multicentric retrospective analysis that included 112 advanced melanoma
patients treated with mono-ICI (Pembrolizumab or Nivolumab) at three Centers in Serbia and Bosnia & Herzegovina.
Data were extracted from the European Melanoma Registry (EuMelaReg). ROC curves with Youdens J-statistic were
used to determine optimal cut-off-values (NLR: 3.35, PLR: 165.5, MLR: 165.5). The p-values regarding Progression-free
survival (PFS and overall survival (OS) were calculated using log-rank (p<0.05; CI 95%).
Results: Each of the inflammatory ratios separately showed poorer prognosis in high-value subgroup in terms of shorter
PFS (NLR: 3.55 vs 14.01- p<0.0001; PLR: 3.85 vs 11.48- p=0.0011; MLR: 5.16 vs 11.48- p=0.0171) and OS (NLR: 5.69 vs
23.59- p<0.0001; PLR: 6.12 vs 23.59- p<0.0001; MLR: 8.42 vs 21.78- p=0.0007). In group analysis, patients with all three
ratios elevated were compared with patients with at least one low ratio. Shorter PFS (2.86 vs 10.56; p<0.0001) and OS

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