Tumor Cellularity and Infiltrating Lymphocytes as a Survival Surrogate in HER2-Positive Breast Cancer

Chic, N; Luen, SJ; Nuciforo, P; Salgado, R; Fumagalli, D; Hilbers, F; Wang, Y; de Azambuja, E; Lang, I; Di Cosimo, S; Saura, C; Huober, J; Prat, A; Loi, S

Author(s): Chic, N; Luen, SJ; Nuciforo, P; Salgado, R; Fumagalli, D; Hilbers, F; Wang, Y; de Azambuja, E; Lang, I; Di Cosimo, S; Saura, C; Huober, J; Prat, A; Loi, S;
Details: Publication Year 2022-03-08,Volume 114,Issue #3,Page 467-470
Journal Title: Journal of the National Cancer Institute
Publication Type: Research article
Abstract: In early-stage HER2-positive breast cancer, biomarkers that guide deescalation and/or escalation of systemic therapy are needed. CelTIL score is a novel, combined biomarker based on stromal tumor-infiltrating lymphocytes and tumor cellularity and is determined in tumor biopsies at week 2 of anti-HER2 therapy only. We evaluated the prognostic value of CelTIL in 196 patients with early-stage HER2-positive disease treated with standard trastuzumab-based chemotherapy in the NeoALTTO phase III trial. Using a prespecified CelTIL cutoff, a better 5-year event-free survival and overall survival was observed between CelTIL-high and CelTIL-low score with a 76.4% (95% confidence interval [CI] = 68.0% to 85.0%) vs 59.7% (95% CI = 50.0% to 72.0%) (hazard ratio = 0.40, 95% CI = 0.17 to 0.94) and 86.4% (95% CI = 80.0% to 94.0%) vs 73.5% (95% CI = 64.0% to 84.0%) (hazard ratio = 0.43, 95% CI = 0.20 to 0.92), respectively. Statistical significance was maintained after adjusting for baseline tumor-infiltrating lymphocytes, hormone receptor status, pretreatment tumor size and nodal status, type of surgery, treatment arm, and pathological complete response. Further studies to support CelTIL as an early readout biomarker to help deescalate or escalate systemic therapy in HER2-positive breast cancer seem warranted.
Keywords: Antineoplastic Combined Chemotherapy Protocols/therapeutic use; Biomarkers, Tumor; *Breast Neoplasms/pathology; Chemotherapy, Adjuvant; Disease-Free Survival; Female; Humans; Lymphocytes, Tumor-Infiltrating; Neoadjuvant Therapy; Receptor, ErbB-2; Trastuzumab; Treatment Outcome
Department(s): Medical Oncology; Laboratory Research
PubMed ID: 33787900
Publisher's Version: https://doi.org/10.1093/jnci/djab057
Terms of Use/Rights Notice: Refer to copyright notice on published article.

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