scholarly journals Predictive and prognostic role of tumour-infiltrating lymphocytes in breast cancer patients with different molecular subtypes: a meta-analysis

BMC Cancer ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Zhao-hua Gao ◽  
Cun-xin Li ◽  
Ming Liu ◽  
Jia-yuan Jiang
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Cancer Patients ◽  
Predictive Value ◽  
Molecular Subtypes ◽  
Molecular Subtype ◽  
Meta Analysis ◽  
Breast Cancer Patients ◽  
Tumour Infiltrating Lymphocytes ◽  
Infiltrating Lymphocytes

Abstract Background Whether tumour-infiltrating lymphocytes (TILs) play different roles in different molecular subtypes of breast cancer remains unknown. Additionally, their prognostic and predictive value in different molecular subtypes of breast cancer is still controversial. The aim of our meta-analysis was to assess the prognostic and predictive value of TILs in different molecular subtypes of breast cancer by summarizing all relevant studies performing multivariate analysis. Methods PubMed, Embase, EBSCO, ScienceDirect, the Cochrane Database and Web of Science were comprehensively searched (until March 2020). Hazard ratios (HRs), odds ratios (ORs) and their 95% confidence intervals (CIs) were used as effect measures to perform our meta-analysis. A random effect model was used. Stata software, version 15 (2017) (StataCorp, College Station, TX, USA) was used to perform the statistical analysis. Results Thirty-three studies including 18,170 eligible breast cancer patients were analysed. The meta-analysis showed that high TIL expression was significantly associated with increased pathological complete response (pCR) rates after neoadjuvant chemotherapy in patients with the HER2-enriched molecular subtype (OR = 1.137, 95% CI [1.061 ~ 1.218], p < 0.001) and triple-negative breast cancer (TNBC) subtype (OR = 1.120, 95% CI [1.061 ~ 1.182], p < 0.001). However, high TIL expression was not significantly associated with high pCR rates after neoadjuvant chemotherapy in patients with the luminal molecular subtype of breast cancer (OR = 1.154, 95% CI [0.789 ~ 1.690], p = 0.460). We carried out a meta-analysis on the HRs of overall survival (OS) and disease-free survival (DFS) to assess the prognostic value of TILs in breast cancer with different molecular subtypes more deeply. Our meta-analysis confirmed that high TILs were associated with significantly improved DFS in patients with the HER2-enriched molecular subtype [HR = 0.940, 95% CI (0.903 ~ 0.979), p = 0.003] and TNBC molecular subtype [HR = 0.907, 95% CI (0.862 ~ 0.954), p < 0.001]. However, high TILs were not associated with significantly better DFS in patients with the luminal molecular subtype of breast cancer [HR = 0.998, 95% CI (0.977 ~ 1.019), p = 0.840]. Furthermore, the results confirmed that high TILs were significantly related to better OS in patients with the HER2-enriched molecular subtype [HR = 0.910, 95% CI (0.866 ~ 0.957), p < 0.001] and TNBC molecular subtype [HR = 0.869, 95% CI (0.836 ~ 0.904), p < 0.001]. Conversely, the summarized results indicated that high TILs were significantly associated with poor OS in patients with the luminal molecular subtype of breast cancer [HR = 1.077, 95% CI (1.016 ~ 1.141), p = 0.012]. Conclusions Our meta-analysis confirms that high TILs are associated with favourable survival and predicts pCR in breast cancer patients with the TNBC and HER2-enriched molecular subtypes.

scholarly journals Predictive and Prognostic Role of Tumor Infiltrating Lymphocytes in Breast Cancer Patients With Different Molecular Subtypes: a Meta-Analysis

2020 ◽  
Author(s):  
Zhao-hua Gao ◽  
Cun-xin Li ◽  
Ming Liu ◽  
Jia-yuan Jiang
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Cancer Patients ◽  
Predictive Value ◽  
Molecular Subtypes ◽  
Molecular Subtype ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Breast Cancer Patients

Abstract Background Whether TILs plays different roles in different molecular subtypes breast cancer remains unknown. The prognostic and predictive value of TILs in different molecular subtypes breast cancer is still controversy. The aim of our meta-analysis is to assess the prognostic and predictive value of TILs in different molecular subtypes breast cancer by summarizing all relevant studies including multivariate analysis.MethodsPubMed, Embase, EBSCO, ScienceDirect, Cochrane Database and the Web of Science were comprehensively retrieved (until March 2020). Hazard ratio (HR), odds ratio (OR) and their 95% confidence intervals (CI) were used as effect measures to perform our meta-analysis. Random effect model was used. Stata software, version 15 (2017) (Stata Corp, College Station, TX, USA) was used to carried out statistical analysis. ResultsThirty-three studies including 18170 eligible breast cancer patients were analyzed. The meta-analysis showed that patients with high TILs expression were significantly correlated with increased pCR after neoadjuvant chemotherapy in HER2 enriched molecular subtype (OR = 1.137, 95% CI [1.061~1.218], p <0.001) and TNBC molecular subtype breast cancer (OR = 1.120, 95% CI [1.061~1.182], p <0.001). But, patients with high TILs expression were not significantly related to high pCR in luminal molecular subtype breast cancer after neoadjuvant chemotherapy (OR =1.154, 95% CI [0.789~1.690], p = 0.460). We carried out this meta-analysis on HR for OS and DFS to assess the prognostic value of TILs in breast cancer with different molecular subtypes more deeply. Our meta-analysis confirmed that high TILs had relationship with a significantly improved DFS in HER2 enriched molecular subtype [HR=0.940, 95%CI (0.903~0.979), p=0.003] and TNBC molecular subtype breast cancer patients [HR=0.907, 95%CI (0.862~0.954), p<0.001]. However, high TILs was not correlated with a significantly better DFS in luminal molecular subtype breast cancer patients [HR=0.998, 95%CI (0.977~1.019), p=0.840]. Furthermore, the results confirmed that high TILs had significant relationship with a better OS in HER2 enriched molecular subtype [HR=0.910, 95%CI (0.866~0.957), p <0.001] and TNBC molecular subtype breast cancer patients [HR=0.869, 95%CI (0.836~0.904), p <0.001]. Conversely, the summarized results indicated that high TILs was significantly correlated with a poor OS in luminal molecular subtype breast cancer patients [HR=1.077, 95%CI (1.016~1.141), p=0.012].ConclusionsOur meta-analysis confirms that high TILs is correlated with favourable survival and predicts pathological complete response in breast cancer patients with TNBC molecular subtypes and HER2-enriched molecular subtypes.

scholarly journals Predictive Value of Tumor Infiltrating Lymphocytes in Neoadjuvant Chemotherapy Treated Breast Cancer: A Meta-Analysis of 8052 Patients

2020 ◽  
Author(s):  
Shiqi Li ◽  
Ying Zhang ◽  
Shujun Wang ◽  
Rui Yang
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Cancer Patients ◽  
Prognostic Value ◽  
Meta Analysis ◽  
Prognostic Significance ◽  
Tumor Infiltrating Lymphocytes ◽  
Breast Cancer Patients ◽  
Infiltrating Lymphocytes ◽  
Positive Breast Cancer

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.

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