Tumor-Infiltrating Lymphocytes Refine Outcomes in Triple-Negative Breast Cancer Treated with Anthracycline-Free Neoadjuvant Chemotherapy.

Autor:	Martín M; Hospital General Universitario Gregorio Marañón, Madrid, Spain.; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.; Centro de Investigación Biomédica en Red de Cáncer, Madrid, Spain.; Grupo Español de Investigación en Cáncer de Mama, Madrid, Spain.; Universidad Complutense de Madrid, Madrid, Spain., Yoder R; The University of Kansas Cancer Center, Westwood, Kansas., Salgado R; ZAS Hospitals, Antwerp, Belgium., Del Monte-Millán M; Hospital General Universitario Gregorio Marañón, Madrid, Spain.; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.; Centro de Investigación Biomédica en Red de Cáncer, Madrid, Spain., Álvarez EL; Hospital General Universitario Gregorio Marañón, Madrid, Spain.; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain., Echavarría I; Hospital General Universitario Gregorio Marañón, Madrid, Spain.; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.; Centro de Investigación Biomédica en Red de Cáncer, Madrid, Spain., Staley JM; The University of Kansas Cancer Center, Westwood, Kansas., O'Dea AP; University of Kansas Medical Center, Westwood, Kansas., Nye LE; University of Kansas Medical Center, Westwood, Kansas., Stecklein SR; University of Kansas Medical Center, Kansas City, Kansas., Bueno C; Hospital Infanta Cristina (Parla), Madrid, Spain., Jerez Y; Hospital General Universitario Gregorio Marañón, Madrid, Spain.; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.; Centro de Investigación Biomédica en Red de Cáncer, Madrid, Spain., Cebollero M; Hospital General Universitario Gregorio Marañón, Madrid, Spain.; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain., Bueno O; Hospital General Universitario Gregorio Marañón, Madrid, Spain.; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain., García Saenz JÁ; Hospital Clínico San Carlos, Madrid, Spain., Moreno F; Hospital General Universitario Gregorio Marañón, Madrid, Spain.; Grupo Español de Investigación en Cáncer de Mama, Madrid, Spain., Bohn U; Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas, Canary Islands., Gómez H; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru., Massarrah T; Hospital General Universitario Gregorio Marañón, Madrid, Spain.; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.; Centro de Investigación Biomédica en Red de Cáncer, Madrid, Spain., Khan QJ; University of Kansas Medical Center, Westwood, Kansas., Godwin AK; University of Kansas Medical Center, Kansas City, Kansas., López-Tarruella S; Hospital General Universitario Gregorio Marañón, Madrid, Spain.; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.; Centro de Investigación Biomédica en Red de Cáncer, Madrid, Spain.; Grupo Español de Investigación en Cáncer de Mama, Madrid, Spain.; Universidad Complutense de Madrid, Madrid, Spain., Sharma P; University of Kansas Medical Center, Westwood, Kansas.
Jazyk:	angličtina
Zdroj:	Clinical cancer research : an official journal of the American Association for Cancer Research [Clin Cancer Res] 2024 May 15; Vol. 30 (10), pp. 2160-2169.
DOI:	10.1158/1078-0432.CCR-24-0106
Abstrakt:	Purpose: Stromal tumor-infiltrating lymphocytes (sTIL) are associated with pathologic complete response (pCR) and long-term outcomes for triple-negative breast cancer (TNBC) in the setting of anthracycline-based chemotherapy. The impact of sTILs on refining outcomes beyond prognostic information provided by pCR in anthracycline-free neoadjuvant chemotherapy (NAC) is not known. Experimental Design: This is a pooled analysis of two studies where patients with stage I (T>1 cm)-III TNBC received carboplatin (AUC 6) plus docetaxel (75 mg/m2; CbD) NAC. sTILs were evaluated centrally on pre-treatment hematoxylin and eosin slides using standard criteria. Cox regression analysis was used to examine the effect of variables on event-free survival (EFS) and overall survival (OS). Results: Among 474 patients, 44% had node-positive disease. Median sTILs were 5% (range, 1%-95%), and 32% of patients had ≥30% sTILs. pCR rate was 51%. On multivariable analysis, T stage (OR, 2.08; P = 0.007), nodal status (OR, 1.64; P = 0.035), and sTILs (OR, 1.10; P = 0.011) were associated with pCR. On multivariate analysis, nodal status (HR, 0.46; P = 0.008), pCR (HR, 0.20; P < 0.001), and sTILs (HR, 0.95; P = 0.049) were associated with OS. At 30% cut-point, sTILs stratified outcomes in stage III disease, with 5-year OS 86% versus 57% in ≥30% versus <30% sTILs (HR, 0.29; P = 0.014), and numeric trend in stage II, with 5-year OS 93% versus 89% in ≥30% versus <30% sTILs (HR, 0.55; P = 0.179). Among stage II-III patients with pCR, EFS was better in those with ≥30% sTILs (HR, 0.16; P, 0.047). Conclusions: sTILs density was an independent predictor of OS beyond clinicopathologic features and pathologic response in patients with TNBC treated with anthracycline-free CbD chemotherapy. Notably, sTILs density stratified outcomes beyond tumor-node-metastasis (TNM) stage and pathologic response. These findings highlight the role of sTILs in patient selection and stratification for neo/adjuvant escalation and de-escalation strategies. (©2024 American Association for Cancer Research.)
Databáze:	MEDLINE
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