Predictive and prognostic value of stromal tumour-infiltrating lymphocytes before and after neoadjuvant therapy in triple negative and HER2-positive breast cancer

• Published in: European journal of cancer (1990) Vol. 118; pp. 41 - 48
• Main Authors: Ochi, Tomohiro, Bianchini, Giampaolo, Ando, Michiko, Nozaki, Fumi, Kobayashi, Daiki, Criscitiello, Carmen, Curigliano, Giuseppe, Iwamoto, Takayuki, Niikura, Naoki, Takei, Hiroyuki, Yoshida, Atsushi, Takei, Junko, Suzuki, Koyu, Yamauchi, Hideko, Hayashi, Naoki
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.09.2019; Elsevier Science Ltd
• Subjects: Breast cancer; ErbB-2 protein; Human epithelial growth factor receptor 2; Impact prediction; Lymphocytes; Multivariate analysis; Pharmacodynamics; Therapy; Triple negative breast cancer; Tumors; Tumour-infiltrating lymphocytes; Human epithelial growth factor receptor 2; Breast cancer; Triple negative breast cancer; Tumour-infiltrating lymphocytes
• ISSN: 0959-8049; 1879-0852
• DOI: 10.1016/j.ejca.2019.05.014

Lymphocyte predominant breast cancer (BC) is associated with higher pathological complete response (pCR) rate after neoadjuvant therapy (NAT) and favorable outcome in triple negative breast cancer (TNBC) and HER2+ BC. The predictive and prognostic impact of stromal tumour-infiltrating lymphocytes (TILs) after NAT and the change of TILs before (pre-) and after (post-) NAT are not well studied. We aimed to assess the predictive and prognostic value of pre- and post-NAT TILs, as well as their pharmacodynamics modulation and their change for TNBC and HER2+ BC. Two-hundred and nine consecutive patients (n = 80 TNBC, n = 129 HER2+ BC) who received NAT between 2001 and 2009 in a single institution were included. We evaluated the association between pre-NAT TILs and pCR, and the association between pre- and post-NAT TILs, as well as their immunodynamics change with relapse-free survival (RFS) for patients with residual disease (RD). Low pre-NAT TILs compared to int/high were significantly associated with lower pCR rate (TNBC: 4.0% vs 43.6%; HER2+ BC: 26.0% vs 51.9%). The median follow-up period was 98 months. In TNBC with RD, low pre-NAT TILs showed significant association with shorter RFS (HR = 3.844 [1.190–12.421], p = 0.024) in multivariate analysis. Low post-NAT TILs showed borderline significant association with shorter RFS (HR = 2.836 [0.951–8.457], p = 0.061). The change in TILs was not associated with RFS. In HER2+ BC, low pre-NAT TILs were not associated with RFS. In TN and HER2+ BCs, low pre-NAT TILs tumours had a low likelihood of achieving pCR. In TNBC with RD, both low pre- and post-NAT TILs were associated with shorter RFS. These results suggest that TILs information should be taken into account when additional therapies may be given in the post-neoadjuvant setting. •In TNBC and HER2+ BC, low pre-NAT TILs were associated with low pCR rate.•Low pre-NAT TILs had strong association with poor prognosis in TNBC.•Low post-NAT TILs were associated with shorter RFS in TNBC with RD.•The change of TILs level during NAT did not associate with RFS.