scholarly journals The Prognostic and Predicting Roles of Tumor-Infiltrating Lymphocytes in Breast Cancer: A Meta-Analysis

2014 ◽  
Vol 6 (1) ◽  
pp. 9-19 ◽  
Author(s):  
Ezzeldin M. Ibrahim ◽  
Meteb Al-Foheidi ◽  
Mubarak M. Al-Mansour ◽  
Ghieth A Kazkaz ◽  
Tahir E. Yunus
2014 ◽  
Vol 32 (26_suppl) ◽  
pp. 138-138 ◽  
Author(s):  
Yan Mao ◽  
Qing Qu ◽  
Yuzi Zhang ◽  
Junjun Liu ◽  
Kunwei Shen

138 Background: Whether tumor-infiltrating lymphocytes (TILs) predict response to neoadjuvant chemotherapy (NAC) remains elusive. Methods: A systematic review and meta-analysis was undertook to establish the relationship between TIL and pathological complete response (pCR) rate in NAC of breast cancer. A PubMed and Web of Science literature search was designed. Studies were included, in which the predictive significance of intratumoral and/or stromal TIL, and/or CD3+, CD4+, CD8+, and FOXP3+ lymphocytes were determined . Pooled ORs and publication bias was evaluated by STATA software. Results: A total of 13 published studies (including 3,555 patients) were eligible. In pooled analysis, higher number of TIL in pre-treatment biopsy was correlated with higher pCR rate of neoadjuvant chemotherapy, and odds ratio (OR) was 3.82 (95% confidence interval (CI), 3.10-4.70), no matter tested in intratumor (OR=3.32, 95% CI: 2.52-4.37), in stroma (OR=4.15,95% CI: 2.94-5.86), or in combined sites (OR=8.98, 95% CI: 3.79,21.30). Moreover, TIL predicts higher pCR rate in triple negative (OR=5.03,95% CI: 2.31-10.97) and HER2+ (OR=5.54,95% CI: 1.39-22.12) patients, but not in hormonal receptor (HR) +/HER2- patients (OR=2.57, 95% CI: 0.20-33.24). For TIL subsets, CD8+ T-lymphocytes predict better pathological response to NAC no matter in pre- (OR=3.36,95%CI: 1.15-9.85) or post-NAC (OR=4.71,95%CI: 1.29-17.27) tissue, while FOXP3+ T-lymphocytes have similar predictive roles only when tested after NAC (OR=4.26, 95%CI: 1.83-9.92).With limited study, the predictive role of CD3+ and CD4+T-lymphoctes were unclear, more perspective studies were needed in future to establish the relationship. Conclusions: High level of TIL in pre-treatment biopsy could be a good marker indicates better pathological response to NAC in triple-negative and HER2+ breast cancer patients. Different subsets have different predictive roles in the pCR rate to NAC. However, significant heterogeneity and an insufficient number of studies underscore the need for further prospective studies on subsets of T lymphocytes and different subtypes of breast cancer to increase the robustness of the analyses.


2019 ◽  
Author(s):  
Guoxuan Gao ◽  
Zihan Wang ◽  
Xiang Qu ◽  
Zhongtao Zhang

Abstract Objective The objective of this systematic review and meta-analysis is to determine prognostic roles of the total tumor-infiltrating lymphocytes (TILs) or subtypes of TILs (CD4+, CD8+, and FOSP3+) for patients with triple-negative breast cancer (TNBC).Methods A systematic literature search was conducted in the databases of MEDLINE, EMBASE, and Web of Science to identified eligible articles before August 2019. Study screening, data extraction, and risk of bias were performed by two independent reviewers. Risk of bias on study level was assessed using an approach based on the ROBINS I tool and the Quality In Prognosis Studies (QUIPS) tool. We performed meta-analyses to obtain a pooled estimate of the prognostic role of TILS using Review Manager 5.3.Results There was total of 37 studies included in the final analysis. Compared to TNBC patients with poor TILs, TNBC patients with rich TILs had a higher pCR to treatments (OR 2.14, 95% CI 1.43-3.19). Along with per 10% increase of the TILs, patients with TNBC had an increased pCR (OR 1.09, 95% CI 1.02-1.16). Compared to TNBC patients with poor TILs, patients with rich TILs had a better OS (HR 0.58, 95% CI 0.48-0.71) and DFS (HR 0.66, 95% CI 0.57-0.76). Addition to, along with a continuous increase of the TILs, patients with TNBC had improved OS (HR 0.90, 95% CI 0.87-0.93) and DFS (HR 0.92, 95% CI 0.90-0.95) as well. CD4+TILs subgroup (rich vs. poor) showed a better OS (HR 0.49, 95%CI 0.32-0.76) and DFS (HR 0.54, 95%CI 0.36-0.80). CD8+TILs subgroup (rich vs. poor) showed a better DFS (HR 0.55, 95% CI 0.38-0.81), but no statistical association was found with OS (HR 0.70, 95% CI 0.46-1.06). FOXP3+TILs subgroup (rich vs. poor) showed a better DFS (HR 0.50, 95% CI 0.33-0.75), but no statistical association was found with OS (HR 1.28, 95% CI 0.24-6.88).Conclusion TNBC with higher levels of TILs showed better short-term and long-term prognosis. The phenotypes of TILs (CD4+TILs, CD8+TILs, and FOXP3+TILs) had positive prediction for long-term prognosis for TNBC.


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