Prognostic value of tumor-infiltrating lymphocytes in patients with early-stage triple-negative breast cancers (TNBC) who did not receive adjuvant chemotherapy

Park, J H; Jonas, Steven; Bataillon, Guillaume; Criscitiello, Carmen; Salgado, Roberto; Loi, S.; Viale, Giuseppe; Lee, H J; Dieci, Maria Vittoria; Kim, S B; Vincent‐Salomon, Anne; Curigliano, Giuseppe; André, Fabrice; Michiels, Stefan

doi:10.1093/annonc/mdz395

Cited by 187 publications

(152 citation statements)

References 15 publications

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“…In a recent pooled analysis of over 2000 TNBC patients, TILs located in the stroma were lower in older individuals, those with larger tumors and those with nodal involvement (78). Further, node negative patients with stromally located TILs >=30% had excellent outcomes, with a 3-year invasive DFS (iDFS) rate of 92% and a median OS of 99%, adding further support to the important role of TILs as a prognostic indicator (78), which appears to be an independent prognostic factor for DFS outcomes (79).…”

Section: Novel Targets Of Interestmentioning

confidence: 82%

Triple negative breast cancer – Understanding the clinical implications of heterogeneity

Gelmon¹,

LeVasseur²

2020

MRAJ

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Triple negative breast cancers (TNBC) have long been associated with a worse prognosis in contrast to hormone receptor (HR) positive and human epidermal growth factor receptor 2 (HER2) positive breast tumours. However, advances in the classification and molecular categorization of TNBC have led to meaningful advances, highlighting substantial TNBC heterogeneity and distinct histomolecular subtypes. While TNBC has historically been treated with single or combined chemotherapeutic agents, novel targeted therapies are being developed and evaluated. A better understanding of oncogenic drivers and the pathogenicity of germline and somatic mutations has also paved the way to new targeted treatments. More recently, the neoadjuvant space has become increasingly popular to better understand the behaviour of TNBC subtypes, leading to the development of biomarker-driven trials to better select targeted treatments. This has ultimately led to a number of advances and new potential targets for treatment which remain under investigation and will undoubtedly lead to a better understanding and personalized approach for patients diagnosed with TNBC.

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Section: Novel Targets Of Interestmentioning

confidence: 82%

Triple negative breast cancer – Understanding the clinical implications of heterogeneity

Gelmon¹,

LeVasseur²

2020

MRAJ

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“…Noteworthy, sTILs may add important information to conventional clinicopathologic factors in order to select a subset of patients who could not derive benefits from chemotherapy. In a large series of more than 500 women affected by pathological stage I TNBC, the presence of sTILs level of at least 30% identified a cohort of patients with excellent prognosis (5-year OS of 98%) without adjuvant chemotherapy [37]. Moreover, the presence of high TILs (>60%) in residual disease after NACT seemed to be correlated with better outcome for TNBC patients in which post-neoadjuvant treatment did not offer additional survival gain [38,39].…”

Section: Tumor Infiltrating Lymphocytes (Tils)mentioning

confidence: 98%

Early Triple Negative Breast Cancer: Conventional Treatment and Emerging Therapeutic Landscapes

Diana

Carlino

Franzese

et al. 2020

Cancers

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Triple negative breast cancers (TNBCs) are characterized by worse prognosis, higher propensity to earlier metastases, and shorter survival after recurrence compared with other breast cancer subtypes. Anthracycline- and taxane-based chemotherapy is still the mainstay of treatment in early stages, although several escalation approaches have been evaluated to improve survival outcomes. The addition of platinum salts to standard neoadjuvant chemotherapy (NACT) remains controversial due to the lack of clear survival advantage, and the use of adjuvant capecitabine represents a valid treatment option in TNBC patients with residual disease after NACT. Recently, several clinical trials showed promising results through the use of poly ADP-ribose polymerase (PARP) inhibitors and by incorporating immunotherapy with chemotherapy, enriching treatment options beyond conventional cytotoxic agents. In this review, we provided an overview on the current standard of care and a comprehensive update of the recent advances in the management of early stage TNBC and focused on the latest emerging biomarkers and their clinical application to select the best therapeutic strategy in this hard-to-treat population.

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“…In other words, medullary carcinomas are now best considered as part of a spectrum of TIL-rich breast cancers. Of note, a recent analysis of the prognostic value of TILs in surgically resected TNBC patients not treated with chemotherapy in the adjuvant setting has shown that a cut-off of 30% of TILs was able to identify patients with extremely good outcome, in the entire population and in stage I disease patients [21]. In addition, another analysis on the value of TIL evaluation in the context of HER2-positive disease has been reported for the Short-HER study: patients with low TILs appeared to benefit from 1-year trastuzumab, whereas patients affected by tumors with high TILs did extremely well with both 1 year and 6 months of trastuzumab-containing chemotherapy [22].…”

Section: Tumor-infiltrating Lymphocytesmentioning

confidence: 99%

The Multifaceted Nature of Tumor Microenvironment in Breast Carcinomas

et al. 2020

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Heterogeneity in breast carcinomas can be appreciated at various levels, from morphology to molecular alterations, and there are well-known genotypic-phenotypic correlations. Clinical decision-making is strictly focused on the evaluation of tumor cells and is based on the assessment of hormone receptors and of the HER2 status, by means of a combination of immunohistochemical and in situ hybridization techniques. The tumor microenvironment (TME) also shows a multifaceted nature stemming from the different actors populating the intratumoral and the peritumoral stroma of breast carcinomas. Of note, we have now evidence that tumor-infiltrating lymphocytes (TILs) are clinically meaningful as their quantification in the intratumoral stroma strongly correlates with good prognosis, in particular in triple-negative and HER2-positive breast cancer patients. Nevertheless, TILs are just one of the many actors orchestrating the com-plexity of the TME, which is populated by immune and nonimmune cells (cancer-associated fibroblasts, cancer-associated adipocytes), as well as non-cellular components such as chemical inflammation mediators. In this review article we will overview the main features of the distinct cell compartments by discussing (i) the potential impact the TME may have on the prognostic stratification of breast cancers and (ii) the possible predictive value of some markers in the context of immunotherapy in light of the recent results of phase III studies in advanced and early triple-negative breast cancer patients.

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Prognostic value of tumor-infiltrating lymphocytes in patients with early-stage triple-negative breast cancers (TNBC) who did not receive adjuvant chemotherapy

Cited by 187 publications

References 15 publications

Triple negative breast cancer – Understanding the clinical implications of heterogeneity

Triple negative breast cancer – Understanding the clinical implications of heterogeneity

Early Triple Negative Breast Cancer: Conventional Treatment and Emerging Therapeutic Landscapes

The Multifaceted Nature of Tumor Microenvironment in Breast Carcinomas

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