Templeton AJ, et al. - In this retrospective analysis, researchers determined the prognostic role of the derived neutrophil-to-lymphocyte ratio (dNLR), across different tumor subtypes, in patients with lymph node-positive, operable early breast cancer enrolled in the GEICAM/9906 trial (a multicenter randomized phase 3 study evaluating adjuvant chemotherapy). Using a Cox proportional hazard analysis, disease-free survival (DFS) and overall survival were explored. dNLR was calculated as the ratio of neutrophils and the difference between total leukocytes and neutrophils in peripheral blood before chemotherapy. Findings showed an independent association of dNLR ≥ 1.35 with worse DFS in the hormone receptor-negative/HER2+ population and in patients with one to three lymph node metastases. There was no significant interaction between the treatment arm and dNLR. Overall, elevated dNLR appeared to be an adverse prognostic factor in hormone receptor-negative early breast cancer.