Prognostic value of histopathologic traits independent of stromal tumor-infiltrating lymphocyte levels in chemotherapy-naïve patients with triple-negative breast cancer.

Autor:	de Boo LW; Department of Molecular Pathology, the Netherlands Cancer Institute, Amsterdam, The Netherlands., Jóźwiak K; Institute of Biostatistics and Registry Research, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany., Ter Hoeve ND; Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands., van Diest PJ; Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands., Opdam M; Department of Molecular Pathology, the Netherlands Cancer Institute, Amsterdam, The Netherlands., Wang Y; Department of Molecular Pathology, the Netherlands Cancer Institute, Amsterdam, The Netherlands., Schmidt MK; Department of Molecular Pathology, the Netherlands Cancer Institute, Amsterdam, The Netherlands; Department of Clinical Genetics, Leiden University Medical Centre, Leiden, The Netherlands., de Jong V; Department of Molecular Pathology, the Netherlands Cancer Institute, Amsterdam, The Netherlands., Kleiterp S; Department of Molecular Pathology, the Netherlands Cancer Institute, Amsterdam, The Netherlands., Cornelissen S; Core Facility Molecular Pathology and Biobanking, Netherlands Cancer Institute, Amsterdam, The Netherlands., Baars D; Department of Biometrics, The Netherlands Cancer Institute, Amsterdam, The Netherlands., Koornstra RHT; Department of Medical Oncology, Rijnstate Medical center, Arnhem, The Netherlands., Kerver ED; Department of Medical Oncology, OLVG, Amsterdam, The Netherlands., van Dalen T; Department of Surgery, Diakonessenhuis Utrecht, Utrecht, The Netherlands., Bins AD; Department of Medical Oncology, Amsterdam UMC, Amsterdam, The Netherlands., Beeker A; Department of Medical Oncology, Spaarne Gasthuis, Hoofddorp, The Netherlands., van den Heiligenberg SM; Department of Medical Oncology, Dijklander Ziekenhuis, Hoorn, The Netherlands., de Jong PC; Department of Medical Oncology, Sint Antonius Hospital, Utrecht, The Netherlands., Bakker SD; Department of Internal Medicine, Zaans Medical Centre, Zaandam, The Netherlands., Rietbroek RC; Department of Medical Oncology, Rode Kruis Hospital, Beverwijk, The Netherlands., Konings IR; Department of Medical Oncology, Amsterdam UMC, Cancer Center Amsterdam, Amsterdam, The Netherlands., Blankenburgh R; Department of Medical Oncology, Saxenburgh Medical Center, Hardenberg, The Netherlands., Bijlsma RM; Department of Medical Oncology, UMC Utrecht Cancer Center, Utrecht, The Netherlands., Imholz ALT; Department of Internal Medicine, Deventer Hospital, Deventer, The Netherlands., Stathonikos N; Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands., Vreuls W; Department of Pathology, Canisius Wilhelmina Ziekenhuis, Nijmegen, The Netherlands., Sanders J; Department of Pathology, Netherlands Cancer Institute, Amsterdam, The Netherlands., Rosenberg EH; Department of Pathology, Netherlands Cancer Institute, Amsterdam, The Netherlands., Koop EA; Department of Pathology, Gelre Ziekenhuizen, Apeldoorn, The Netherlands., Varga Z; Department of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland., van Deurzen CHM; Department of Pathology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands., Mooyaart AL; Department of Pathology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands., Córdoba A; Department of Pathology, Complejo Hospitalaria de Navarra, Pamplona, Spain., Groen E; Department of Pathology, Netherlands Cancer Institute, Amsterdam, The Netherlands., Bart J; Department of Pathology and Medical Biology, University Medical Center Groningen, Groningen, The Netherlands., Willems SM; Department of Pathology and Medical Biology, University Medical Center Groningen, Groningen, The Netherlands., Zolota V; Department of Pathology, Rion University Hospital, Patras, Greece., Wesseling J; Department of Molecular Pathology, the Netherlands Cancer Institute, Amsterdam, The Netherlands; Department of Pathology, Netherlands Cancer Institute, Amsterdam, The Netherlands; Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands., Sapino A; Department of Medical Sciences, University of Torino, Torino, Italy; Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy., Chmielik E; Tumor Pathology Department, Maria Sklodowska-Curie Memorial National Research Institute of Oncology, Gliwice, Poland., Ryska A; Charles University Medical Faculty and University Hospital, Hradec Kralove, Czech Republic., Broeks A; Core Facility Molecular Pathology and Biobanking, Netherlands Cancer Institute, Amsterdam, The Netherlands., Voogd AC; Department of Epidemiology, Maastricht University, Maastricht, The Netherlands; Department of Research and Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, The Netherlands., van der Wall E; Cancer Center, University Medical Center Utrecht, Utrecht, The Netherlands., Siesling S; Department of Research and Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, The Netherlands; Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, Enschede, The Netherlands., Salgado R; Division of Clinical Medicine and Research, Peter MacCallum Cancer Centre, Melbourne, Australia; Department of Pathology, GZA-ZNA Hospitals, Antwerp, Belgium., Dackus GMHE; Department of Molecular Pathology, the Netherlands Cancer Institute, Amsterdam, The Netherlands; Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands., Hauptmann M; Institute of Biostatistics and Registry Research, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany., Kok M; Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands; Department of Tumorbiology & Immunology, The Netherlands Cancer Institute, Amsterdam, The Netherlands., Linn SC; Department of Molecular Pathology, the Netherlands Cancer Institute, Amsterdam, The Netherlands; Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands; Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands. Electronic address: s.linn@nki.nl.
Jazyk:	angličtina
Zdroj:	ESMO open [ESMO Open] 2024 Mar; Vol. 9 (3), pp. 102923. Date of Electronic Publication: 2024 Mar 06.
DOI:	10.1016/j.esmoop.2024.102923
Abstrakt:	Background: In the absence of prognostic biomarkers, most patients with early-stage triple-negative breast cancer (eTNBC) are treated with combination chemotherapy. The identification of biomarkers to select patients for whom treatment de-escalation or escalation could be considered remains an unmet need. We evaluated the prognostic value of histopathologic traits in a unique cohort of young, (neo)adjuvant chemotherapy-naïve patients with early-stage (stage I or II), node-negative TNBC and long-term follow-up, in relation to stromal tumor-infiltrating lymphocytes (sTILs) for which the prognostic value was recently reported. Materials and Methods: We studied all 485 patients with node-negative eTNBC from the population-based PARADIGM cohort which selected women aged <40 years diagnosed between 1989 and 2000. None of the patients had received (neo)adjuvant chemotherapy according to standard practice at the time. Associations between histopathologic traits and breast cancer-specific survival (BCSS) were analyzed with Cox proportional hazard models. Results: With a median follow-up of 20.0 years, an independent prognostic value for BCSS was observed for lymphovascular invasion (LVI) [adjusted (adj.) hazard ratio (HR) 2.35, 95% confidence interval (CI) 1.49-3.69], fibrotic focus (adj. HR 1.61, 95% CI 1.09-2.37) and sTILs (per 10% increment adj. HR 0.75, 95% CI 0.69-0.82). In the sTILs <30% subgroup, the presence of LVI resulted in a higher cumulative incidence of breast cancer death (at 20 years, 58%; 95% CI 41% to 72%) compared with when LVI was absent (at 20 years, 32%; 95% CI 26% to 39%). In the ≥75% sTILs subgroup, the presence of LVI might be associated with poor survival (HR 11.45, 95% CI 0.71-182.36, two deaths). We confirm the lack of prognostic value of androgen receptor expression and human epidermal growth factor receptor 2 -low status. Conclusions: sTILs, LVI and fibrotic focus provide independent prognostic information in young women with node-negative eTNBC. Our results are of importance for the selection of patients for de-escalation and escalation trials. Competing Interests: Disclosure PJvD has advisory relationships with Paige, Pantarei and Samantree, paid to the institution, and research grants paid to the institute from Pfizer. NS received institutional research funding from Pfizer. ZV has a consulting role for Roche. CHMvD received institutional research funding from AstraZeneca/Daiichi Sankyo. SMW has a consulting role for Roche, and received institutional research funding from Roche, Pfizer, Bayer, MSD, AstraZeneca/Merck and Amgen. SMW has a consulting role for IDDI, Sensorion, Biophytis, Servier, Yuhan, Amaris Consulting and Roche. JW received institutional research funding from Cancer Research UK and KWF Dutch Cancer Society. AR has a consulting role for MSD Oncology, Amgen, Roche, AstraZeneca/Daiichi Sankyo and Bristol Myers Squibb/Pfizer. SCL reports grants from ZonMw and A Sister’s Hope during the conduct of the study; has been an advisory board member for AstraZeneca, Cergentis, IBM, Novartis, Pfizer, Sanofi and Roche; and received institutional research grants from Agendia, AstraZeneca, Eurocept-pharmaceuticals and Merck and Pfizer. In addition, SCL received institutional research grants and institutional non-financial support from Agendia, Genentech, Novartis, Roche, Tesaro and Immunomedics and other institutional support from AstraZeneca, Pfizer, Cergentis, Daiichi Sankyo, IBM and Bayer outside the submitted work. MK is an advisory board member and/or received speakers’ fee for/from Alderaan, Bristol Myers Squibb (BMS), Domain Therapeutics, Gilead, Roche, Medscape, MSD and AZ/Daiichi and received institutional research support from AstraZeneca/Daiichi, BMS and Roche outside the submitted work. RS reports non-financial support from Merck and BMS, research support from Merck, Puma Biotechnology and Roche, and personal fees from Roche, BMS and Exact Sciences for advisory boards. IRK received research grants from Novartis and Gilead. RHTK is an advisory board member for Amgen, AstraZeneca, Bayer, BMS, MSD, Novartis, Pfizer, Pierre Fabre Sante, Sanofi and Servier. All other authors have declared no conflicts of interest. (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
Databáze:	MEDLINE
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