scholarly journals Predictive value of improvement in the immune tumour microenvironment in patients with breast cancer treated with neoadjuvant chemotherapy

ESMO Open ◽  
2018 ◽  
Vol 3 (6) ◽  
pp. e000305 ◽  
Author(s):  
Wataru Goto ◽  
Shinichiro Kashiwagi ◽  
Yuka Asano ◽  
Koji Takada ◽  
Katsuyuki Takahashi ◽  
...  

BackgroundTumour-infiltrating lymphocytes (TILs) can be used to monitor the immune tumour microenvironment (iTME) and predict treatment response and outcome in breast cancer. We evaluated the prognostic significance of the levels of CD8+ TILs and forkhead box protein (FOXP3)-positive TILs before and after neoadjuvant chemotherapy (NAC).Patients and methodsWe examined 136 patients with breast cancer treated with NAC. The number of CD8+ TILs and FOXP3+ TILs in biopsy specimens and residual tumours was evaluated by immunohistochemistry.ResultsPatients with a high rate of change in the CD8/FOXP3 ratio (CFR) had significantly better recurrence-free survival (RFS) (p<0.001, log-rank). In multivariate analysis, the rates of change in the CD8+ TIL levels and the CFR were independent predictors for RFS (HR=2.304, p=0.036 and HR=4.663, p<0.001). In patients with triple-negative and hormone receptor-positive breast cancer, the rate of change in the CFR was an independent predictor for RFS (HR=13.021, p=0.002 and HR=4.377, p=0.003).ConclusionImprovement in the iTME following NAC is correlated with good outcome. The rate of change in the CFR may be a useful biomarker to predict prognosis of patients treated with NAC.

2008 ◽  
Vol 116 (1) ◽  
pp. 53-68 ◽  
Author(s):  
Robin L. Jones ◽  
Janine Salter ◽  
Roger A’Hern ◽  
Ash Nerurkar ◽  
Marina Parton ◽  
...  

2021 ◽  
Author(s):  
Yuka Asano ◽  
Shinichiro Kashiwagi ◽  
Rika Kouhashi ◽  
Akimichi Yabumoto ◽  
Koji Takada ◽  
...  

Abstract Background: Tumor-infiltrating lymphocytes (TILs), which are indicators for monitoring an immune response, are generally mononuclear immunocytes that aggregate with tumors and are thought to have a close relationship with cancer cells. On the other hand, a fibrotic focus (FF) within the stroma of a tumor is a histological formation that plays an important role in the cancer microenvironment with regard to proliferation and development. Here, we focus on TILs that exist within the FF and we have performed pathological evaluations.Methods: Of the 320 patients were treated with neoadjuvant chemotherapy (NAC), 239 subjects who were able to evaluate FF-TILs were targeted. Lymphocytes that infiltrate the FF are FF-TILs.Results: The disease-free survival (DFS) period after NAC for the high-FF-TIL group was found to be significantly longer than that for the low-FF-TIL group for all cases (p < 0.001) and for all subtypes of triple-negative breast cancer (TNBC) (p = 0.001), human epidermal growth factor receptor 2-enriched breast cancer (HER2BC) (p = 0.010), and hormone receptor-positive breast cancer (HRBC) (p = 0.003). In multivariable analysis as well, high-FF-TIL group classification was an independent factor for recurrence after NAC for all cases (p < 0.001, hazard ratio (HR) = 0.198) and all subtypes of TNBC (p = 0.006, HR = 0.172), HER2BC (p = 0.025, HR = 0.135), and HRBC (p = 0.007, HR = 0.228).Conclusions: It is suggested that FF-TILs are a useful factor for predicting recurrence of breast cancer after NAC.Article headings: NAC for breast cancer by evaluation of FF-TILs


2020 ◽  
Author(s):  
Shiqi Li ◽  
Ying Zhang ◽  
Shujun Wang ◽  
Rui Yang

Abstract Background: We conducted a meta-analysis to determine the prognostic value of Tumor infiltrating lymphocytes (TILs) for patients with breast cancer on Neoadjuvant Chemotherapy, to explore the prognostic value of different TILs threshold in terms of pathological complete response (PCR).Methods: A systematic search of PubMed, EMBASE and Web of Science electronic databases was conducted to identify eligible articles published before September 2020. Data from studies were analyzed by using Review Manager 5.3 and Stata 15.0Results: A total of 22 published studies (including 8 052 patients) were eligible. Patients with high TILs level showed a higher rate of PCR to treatment (OR=3.182, 95 %CI, 2.549-3.973) compared to breast cancer patients with low TILs level. Although the association of TILs with response to neoadjuvant chemotherapy was similar across most breast cancer subtypes, there were a few differences ER negative or ER positive breast cancer. In studies (Type of breast cancer not clearly classified in the literature) where the cut-off value for TILs was ≥10 %, higher levels of total TILs predicted a higher PCR rate of Neoadjuvant Chemotherapy. However, for HER2-positive breast cancer patients, when a cut-off valve of TILs ≥ 30 % was used, the OR was 2.631 (95 % CI, 1.739-3.982, P = 0.000). TILs also were related to better DFS (HR=0.95, 95 %CI, 0.92-0.98, P=0.000) and overall survival (OS) (HR=0.90, 95 %CI, 0.85-0.95, P<0.0001) after Neoadjuvant Chemotherapy.Conclusions: TILs can be used as predictors of patients with breast cancer on Neoadjuvant Chemotherapy. TILs threshold with the greatest prognostic significance of PCR is as yet unknown, but a TILs threshold of at least 30 % is associated with the most powerful outcome prognostication of PCR.


2013 ◽  
Vol 36 (6) ◽  
pp. 297 ◽  
Author(s):  
Peng Xing ◽  
Ji-Guang Li ◽  
Feng Jin ◽  
Ting-Ting Zhao ◽  
Qun Liu ◽  
...  

Purpose: Obesity has been recognized as a significant risk factor for postmenopausal breast cancer. The aim of this study is to investigate the prognostic significance of body mass index (BMI) in hormone receptor-positive, operable breast cancer. Methods: In this retrospective cohort study, 1,192 consecutive patients with curative resection of primary breast cancer were enrolled. Patients were assigned to two groups according to BMI: normal or underweight (BMI < 23.0 kg/m2) and overweight or obese (BMI ≥23.0 kg/m2). Associations among BMI and clinicopathological characteristics and prognosis of patients were assessed. Results: A high BMI was significantly (P < 0.01) correlated with age, nodal stage, ALNR, ER positivity, PR positivity and menopausal status at diagnosis. Univariate analysis revealed that BMI, pathologic T stage, nodal stage, axillary lymph node ratio (ALNR) and adjuvant radiotherapy history were significantly (P < 0.05) associated with disease-free survival and overall survival, irrespective of tumour hormone receptor status. Multivariate analysis revealed BMI as an independent prognostic factor in all cases and in hormone receptor-positive cases. Conclusion: A high BMI (≥23.0 kg/m^2) is independently associated with poor prognosis in hormone receptor-positive breast cancer.


2021 ◽  
pp. 1-6
Author(s):  
Upik A. Miskad ◽  
Rizki A. Rifai ◽  
Rina Masadah ◽  
Berti Nelwan ◽  
Djumadi Ahmad ◽  
...  

BACKGROUND: The immune system is known to play an important role in tumor cell eradication. Although cancer cells were able to escape from the immune system, many studies showed mononuclear inflammatory cell infiltrates known as tumor-infiltrating lymphocytes (TILs) on breast cancer histopathology specimens showed better prognosis, including in disease-free survival (DFS) and chemotherapy responses. OBJECTIVE: This study aimed to reveal the predictive value of tumor-infiltrating lymphocytes (TILs) levels and CD8 expression in invasive breast carcinoma of no special type patients’ samples on response to anthracycline-based neoadjuvant chemotherapy. METHODS: 75 pre-treatment biopsy samples that were diagnosed as invasive breast carcinoma of no special type were evaluated. TILs level determined following recommendations of International TILs Working Group 2014, CD8 expression assessed semiquantitatively after immunohistochemistry staining. Response to anthracycline-based neoadjuvant chemotherapy evaluated clinically using Response Evaluation Criteria in Solid Tumours (RECIST) criteria and pathologically by evaluating hematoxylin and eosin (H&E)-stained slides from mastectomy specimens after 3 or 4 cycles of neoadjuvant chemotherapy. RESULTS: Chi-squared analysis showed a significant relationship between TILs level and CD8 expression with chemotherapy responses clinically (p = 0.011 and p = 0.017 respectively) but not pathologically. Furthermore, the logistic regression test exhibit the predictive value of TILs level was 66.7% and CD8 expression was 64%. CONCLUSIONS: This study results suggest that TILs level and CD8 expression may be added as predictive factors to the response of anthracycline-based neoadjuvant chemotherapy, and oncologists may take benefit in breast cancer patient’s management.


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