The therapeutic candidate for immune checkpoint inhibitors elucidated by the status of tumor-infiltrating lymphocytes (TILs) and programmed death ligand 1 (PD-L1) expression in triple negative breast cancer (TNBC)

Breast Cancer ◽  
2017 ◽  
Vol 25 (1) ◽  
pp. 34-42 ◽  
Author(s):  
Nobumoto Tomioka ◽  
Manabu Azuma ◽  
Mayuko Ikarashi ◽  
Mitsugu Yamamoto ◽  
Masako Sato ◽  
...  
2015 ◽  
Vol 33 (28_suppl) ◽  
pp. 157-157
Author(s):  
Nobumoto Tomioka ◽  
Manabu Azuma ◽  
Kanako Hagio ◽  
Mayuko Ikarashi ◽  
Masako Satoh ◽  
...  

157 Background: The status of tumor infiltrating lymphocytes (TILs) is known to be prognostic for triple negative breast cancer (TNBC) due to its correlation with chemosensitivity. Moreover, to regulate the pathway of immune-checkpoint molecules is also expected to improve the prognosis of TNBC. The relevancy of these two factors could be attractive concerning on the immune interaction which might play an important role in the prognosis of TNBC. Methods: Patients with TNBC are 277 among 2371 who were underwent surgery between January 2002 and December 2011. Out of 90 patients received preoperative systemic therapy (PST), 32 patients’ specimens of core needle biopsy were available for review for TILs. The TILs was scored as “% stromal” by pathologist who feels comfortable with through the scan for single whole section according to the recommendations by an International TILs Working Group 2014. The expression of programmed death ligand 1 (PD-L1) was assessed by immunohistochemistry, which was defined 3 stages as negative or positive (weak or strong) by the pathologist in our facility. The statistical analysis for variance was done by Mann-Whitney U-test or Kruskal-Wallis test, and for survival by Kaplan Meier method was evaluated by Logrank test. Results: TILs’ score was defined as follows (%; numbers of patients): (5; 2), (10; 8), (20; 9), (30; 7), (40; 1), (50; 1), (60; 1), (70; 2), (80; 0), (90; 1). Statistical validations for variance of TILs’ score were significant on the regression rate of tumor size: (T-pT)/T; < 2/3 v.s. 2/3 < (p= 0.0097), and pathological therapeutic grade: 1 vs 2 or 3 (p= 0.0285). When we set the threshold at 30% of TILs’ score, DFS with TILs’ score < 30% was worse significantly (p= 0.0383) but not on OS (p= 0.0772). Unfavorable group on DFS (TILs’ score < 30%) was divided again into two groups by the status of PD-L1 significantly (negative or weak v.s. strong; p= 0.0319). Conclusions: The status of TILs and PD-L1 could elucidate the candidate for the therapeutic approaches to immune-checkpoint molecules, which could make improvement of the prognosis of TNBC.


Cancers ◽  
2021 ◽  
Vol 13 (19) ◽  
pp. 4883
Author(s):  
Marcus Schmidt ◽  
Anne-Sophie Heimes

The role of the immune system in breast cancer has been debated for decades. The advent of technologies such as next generation sequencing (NGS) has elucidated the crucial interplay between somatic mutations in tumors leading to neoantigens and immune responses with increased tumor-infiltrating lymphocytes and improved prognosis of breast cancer patients. In particular, triple-negative breast cancer (TNBC) has a higher mutational burden compared to other breast cancer subtypes. In addition, higher levels of tumor-associated antigens suggest that immunotherapies are a promising treatment option, specifically for TNBC. Indeed, higher concentrations of tumor-infiltrating lymphocytes are associated with better prognosis and response to chemotherapy in TNBC. An important target within the cancer immune cell cycle is the “immune checkpoint”. Immune checkpoint inhibitors (ICPis) block the interaction of certain cell surface proteins that act as “brakes” on immune responses. Recent studies have shown that ICPis improve survival in both early and advanced TNBC. However, this comes at the price of increased toxicity, particularly immune-mediated toxicity. As an alternative approach, individualized mRNA vaccination strategies against tumor-associated neoantigens represent another promising approach leading to neoantigen-specific immune responses. These novel strategies should help to improve treatment outcomes, especially for patients with triple negative breast cancer.


2021 ◽  
Vol 12 ◽  
Author(s):  
Shafei Wu ◽  
Xiaohua Shi ◽  
Jing Wang ◽  
Xuefei Wang ◽  
Yuanyuan Liu ◽  
...  

Background and AimPoor response to immune checkpoint inhibitors (ICIs) has been observed in most triple-negative breast cancer (TNBC) cases (around 80%). Our aim was to investigate the status of mismatch repair (MMR), microsatellite instability (MSI), programmed death-ligand 1 (PD-L1), and lymphocyte-activation gene 3 (LAG-3) in TNBC.MethodsA total of 74 TNBC samples were retrospectively analyzed. MMR and MSI were evaluated by immunohistochemistry (IHC) and polymerase chain reaction (PCR) using Promega 1.2 and NCI panels, respectively. PD-L1, LAG-3, and CD8 expression was assessed by IHC.ResultsNone of the cases demonstrated deficient MMR (dMMR) or MSI. In total, 43/74 cases (58.1%) were PD-L1+, including 1 tumor PD-L1+, 25 tumor-infiltrating lymphocytes (TILs) PD-L1+, and 17 cases involving concurrence of tumor and TIL PD-L1+. The rate of TIL PD-L1+ was remarkably higher than that of tumor PD-L1+ (P&lt;0.001). We identified 20 LAG-3+ cases (27.0%, 20/74), all of which were PD-L1+. Co-expression of PD-L1 and LAG-3 was noted in 46.5% (20/43) of the PD-L1+ population. In the LAG-3+ subtype (co-expression of PD-L1 and LAG-3), high correlation between TILs PD-L1+ and LAG-3+ was observed (P&lt;0.01). A high frequency of CD8+ (98.6%, 73/74) was observed.ConclusiondMMR/MSI characteristics may not be a practical predictive marker for ICIs in TNBC. PD-L1+ is more common in TILs than in tumors. In the PD-L1+ population, approximately half of the cases showed LAG-3 co-expression. For patients with a poor response to PD-1(L1) mono ICI, dual blockade of PD-1(L1) and LAG-3 may be a viable option for the management of TNBC.


Sign in / Sign up

Export Citation Format

Share Document