Immunological profile could be responsible of the unusual long-lasting cutaneous-only breast cancer recurrence: An observational study.

Abstract

e13000 Background: A small number of breast cancer patients develops long-lasting loco-regional cutaneous recurrent disease with a delayed appearance of systemic disease. We recently have observed a favourable immunological signature in one patient and thereafter we looked back to the institutional series to formulate a possible hypothesis. Methods: Two datasets of resistant and metastatic solid tumors (362 Agilent microarrays and 169 RNA sequencing), have been studied. Three immunological signatures have been applied (T-cell inflamed, Cytolysis and TMM) and patients with at least one positive signature have been identified. Results: Preliminary evidence identified, from our genomic and transcriptomic advanced breast cancer database (73 patients and 80 procedures), three patients (4%) with loco-regional only cutaneous recurrent disease. Two patients (#1 and #2) were Hormone Receptor-negative, HER2 receptor-positive with a long-lasting breast cancer cutaneous recurrence (57 and 42 months, respectively) until bone (#1) or visceral (pleura and liver) (#2) progression. Patient #3 is a Hormone Receptor-positive, HER2-negative breast cancer that has recently developed an ipsilateral cutaneous (breast) recurrence so we do not have a follow up. Patient #1 had 4 transcriptomic tests, patient #2 had 2 tests and #3 one test. Biopsies were obtained from cutaneous lesions. According to our database, 25 out 80 procedures (31.25%) showed at least one favourable immunological signature (Table). In patients #1 and #2 with consecutive genomic testing, the immunological profile got worse with the resistance to therapies before systemic progression. Conclusions: According to our observation, a positive immunological signature was associated with a loco-regional cutaneous breast cancer recurrence and an unusually prolonged course of the disease. This observation should be confirmed in larger trials with more patients. Immunotherapy might play a role in the management of this clinical situation. None of these 3 patients had a triple negative phenotype for which immunotherapy has been found active. Ayers et al. J Clin Oncol 2017; 127 (8):2930-2940. Yang et al. Clin Cancer Res 2020; 26(8):3296-3306. Manzano et al. BMC Cancer 2021: 432.[Table: see text]