Prediction of Treatment Response to Neoadjuvant Chemotherapy in Breast Cancer by Subtype Using Tumor-infiltrating Lymphocytes
Prediction of Treatment Response to Neoadjuvant Chemotherapy in Breast Cancer by Subtype Using Tumor-infiltrating Lymphocytes
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DOI：
10.21873/anticanres.12476
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发表时间：
2018-04-01
影响因子：
2
通讯作者：
Ohira, Masaichi
中科院分区：
文献类型：
--
作者：
Asano, Yuka;Kashiwagi, Shinichiro;Ohira, Masaichi
背景/目的：最近的兴趣集中在肿瘤浸润淋巴细胞（TIL）的乳腺癌（BC）的治疗效果和结果的意义。基于最新的国际建议，以标准化的评价方法，TILs的临床有效性和实用性进行了新辅助化疗（NAC）的患者进行了调查，在本研究中。患者和方法：在177例接受NAC治疗和随后的根治性手术的BC患者中评价了TILs。回顾性研究了根据标准方法评估的TIL与预后（包括NAC的疗效）之间的相关性。结果如下：与低TIL组（n= 81）相比，在高TIL组（n= 96）中，三阴性乳腺癌（TNBC）（p< 0.001）和人表皮生长因子受体2富集的乳腺癌（HER 2BC）（p= 0.040）显著更频繁，并且病理学完全缓解（pCR）率显著更高（p= 0.003）。在TNBC患者和HER 2BC患者中，高TIL组的pCR率显著高于低TIL组（分别为p= 0.013和p= 0.014）。多变量分析还显示，高TIL状态是预测有利预后的独立因素（风险比（HR）= 0.24，p= 0.023和HR= 0.13，p= 0.036）。成功NAC后局部复发的活检标本经常显示TIL减少。结论：TIL可能是预测TNBC和HER 2BC患者对NAC治疗反应的生物标志物。TIL的减少也可能与肿瘤复发相关。
Background/Aim: Recent interest has focused on the significance of tumor-infiltrating lymphocytes (TILs) on the efficacies and outcomes of the treatment in breast cancer (BC). Based on the recent international recommendation to standardize the evaluation method, the clinical validity and utility of TILs in patients who underwent neoadjuvant chemotherapy (NAC) were investigated in the present study. Patients and Methods: TILs were evaluated in 177 patients with BC treated with NAC and subsequent curative surgery. The correlation between TILs evaluated according to the standard method and prognosis, including the efficacy of NAC, was investigated retrospectively. Results: In the high-TIL group (n= 96) compared to the low-TIL group (n= 81), triple-negative breast cancer (TNBC) (p< 0.001) and human epidermal growth factor receptor 2-enriched breast cancer (HER2BC) (p= 0.040) were significantly more frequent, and the pathological complete response (pCR) rate was significantly higher (p= 0.003). Among patients with TNBC and those with HER2BC, the pCR rate was significantly higher in the high-TIL group than in the low-TIL group (p= 0.013 and p= 0.014, respectively). Multivariable analysis also showed that high-TIL status was an independent factor predicting favorable prognosis (hazard ratio(HR)= 0.24, p= 0.023 and HR= 0.13, p= 0.036). Biopsy specimens from local recurrence after successful NAC frequently showed TILs decreased. Conclusion: TILs may be a biomarker for predicting treatment response to NAC in patients with TNBC and HER2BC. A decrease in TILs may also be associated with tumor recurrence.