Abstract
BackgroundThe presence of tumor-infiltrating lymphocytes has been associated with prognosis and chemotherapy response, particularly in high-risk breast cancer subtypes. There is limited data so far as to (i) how tumor-infiltrating lymphocyte (TIL) measurements correlate with genomic measurements such as the Oncotype DX Recurrence Score® and (ii) whether the survival impact of TIL measurements varies according to different adjuvant systemic therapies.MethodsThe WSG PlanB trial compared an anthracycline-free chemotherapy regimen (6x docetaxel/cyclophosphamide, TC) to an anthracycline-taxane sequence (4xEC followed by 4x docetaxel) in patients with intermediate-risk, HER2-negative early breast cancer (EBC). Patients with HR-positive HER2-negative EBC were further stratified to receive endocrine therapy alone vs. chemotherapy followed by endocrine therapy based on Recurrence Score results and nodal status. In this analysis, three independent observers quantified and categorized the presence of TILs among tumor samples from patients in PlanB. TIL measurements were correlated with clinical/pathological parameters and treatment outcome overall and according to the treatment arm.ResultsDisease-free survival (DFS) rates were significantly better (p = .04) in HR-negative patients with high vs. intermediate TIL levels and were higher in low vs. intermediate TIL patients, however with borderline significance only (p = .06). There were no significant differences among TIL categories in HR+ patients. High RS categories, HR-negative status, and high KI67 were independently and significantly associated with high TIL categories. There was no significant impact of TIL category on DFS in patients treated by endocrine therapy only; however, in patients receiving chemotherapy, DFS in the intermediate TIL category was lower than that in the other categories.ConclusionAlthough the presence of high TILs is associated with negative prognostic parameters such as high KI67 and HR-negative status among patients with HR-positive HER2-negative EBC, patients with high TILs show a favorable 5-year DFS in both HR-positive/HER2-negative and triple-negative breast cancer.
Highlights
The presence of tumor-infiltrating lymphocytes has been associated with prognosis and chemotherapy response, in high-risk breast cancer subtypes
Conclusion: the presence of high tumor-infiltrating lymphocyte (TIL) is associated with negative prognostic parameters such as high KI67 and hormone receptor-positive (HR)-negative status among patients with HR-positive HER2-negative early breast cancer (EBC), patients with high TILs show a favorable 5-year Disease-free survival (DFS) in both HR-positive/HER2-negative and triple-negative breast cancer
Our analyses showed a significant association between stromal tumor-infiltrating lymphocytes (sTILs) measurements and HR status, Ki67 categories, and Recurrence Score categories
Summary
The presence of tumor-infiltrating lymphocytes has been associated with prognosis and chemotherapy response, in high-risk breast cancer subtypes. TILs have been associated with prognosis and with chemotherapy response in early breast cancer (EBC), in the presence of other high-risk features [4, 5], and may help to guide therapy decisions. Recurrence Score® (RS) results were incorporated for risk stratification in hormone receptor-positive (HR) breast cancer; of these, 348 (low RS) patients received endocrine therapy alone; overall, 2449 patients were randomized to antacycline-free (6xTC) vs standard anthracycline-taxane chemotherapy (4xEC-4xDoc) [8]. Since the Oncotype DX Recurrence Score was evaluated in a significant fraction of patients with HRpositive breast cancer after an early amendment of the trial, we were able to correlate TIL measurements with RS results
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
