Prognostic Value of Stromal Tumor-Infiltrating Lymphocytes in Young, Node-Negative, Triple-Negative Breast Cancer Patients Who Did Not Receive (neo)Adjuvant Systemic Therapy

de Jong, VMT; Wang, Y; Ter Hoeve, ND; Opdam, M; Stathonikos, N; Jozwiak, K; Hauptmann, M; Cornelissen, S; Vreuls, W; Rosenberg, EH; Koop, EA; Varga, Z; van Deurzen, CHM; Mooyaart, AL; Cordoba, A; Groen, EJ; Bart, J; Willems, SM; Zolota, V; Wesseling, J; Sapino, A; Chmielik, E; Ryska, A; Broeks, A; Voogd, AC; Loi, S; Michiels, S; Sonke, GS; van der Wall, E; Siesling, S; van Diest, PJ; Schmidt, MK; Kok, M; Dackus, GMHE; Salgado, R; Linn, SC

Author(s): de Jong, VMT; Wang, Y; Ter Hoeve, ND; Opdam, M; Stathonikos, N; Jozwiak, K; Hauptmann, M; Cornelissen, S; Vreuls, W; Rosenberg, EH; Koop, EA; Varga, Z; van Deurzen, CHM; Mooyaart, AL; Cordoba, A; Groen, EJ; Bart, J; Willems, SM; Zolota, V; Wesseling, J; Sapino, A; Chmielik, E; Ryska, A; Broeks, A; Voogd, AC; Loi, S; Michiels, S; Sonke, GS; van der Wall, E; Siesling, S; van Diest, PJ; Schmidt, MK; Kok, M; Dackus, GMHE; Salgado, R; Linn, SC;
Details: Publication Year 2022-07-20,Volume 40,Issue #21,Page 2361-2374
Journal Title: Journal of Clinical Oncology
Publication Type: Research article
Abstract: PURPOSE: Triple-negative breast cancer (TNBC) is considered aggressive, and therefore, virtually all young patients with TNBC receive (neo)adjuvant chemotherapy. Increased stromal tumor-infiltrating lymphocytes (sTILs) have been associated with a favorable prognosis in TNBC. However, whether this association holds for patients who are node-negative (N0), young (< 40 years), and chemotherapy-naive, and thus can be used for chemotherapy de-escalation strategies, is unknown. METHODS: We selected all patients with N0 TNBC diagnosed between 1989 and 2000 from a Dutch population-based registry. Patients were age < 40 years at diagnosis and had not received (neo)adjuvant systemic therapy, as was standard practice at the time. Formalin-fixed paraffin-embedded blocks were retrieved (PALGA: Dutch Pathology Registry), and a pathology review including sTILs was performed. Patients were categorized according to sTILs (< 30%, 30%-75%, and >/= 75%). Multivariable Cox regression was performed for overall survival, with or without sTILs as a covariate. Cumulative incidence of distant metastasis or death was analyzed in a competing risk model, with second primary tumors as competing risk. RESULTS: sTILs were scored for 441 patients. High sTILs (>/= 75%; 21%) translated into an excellent prognosis with a 15-year cumulative incidence of a distant metastasis or death of only 2.1% (95% CI, 0 to 5.0), whereas low sTILs (< 30%; 52%) had an unfavorable prognosis with a 15-year cumulative incidence of a distant metastasis or death of 38.4% (32.1 to 44.6). In addition, every 10% increment of sTILs decreased the risk of death by 19% (adjusted hazard ratio: 0.81; 95% CI, 0.76 to 0.87), which are an independent predictor adding prognostic information to standard clinicopathologic variables (chi(2) = 46.7, P < .001). CONCLUSION: Chemotherapy-naive, young patients with N0 TNBC with high sTILs (>/= 75%) have an excellent long-term prognosis. Therefore, sTILs should be considered for prospective clinical trials investigating (neo)adjuvant chemotherapy de-escalation strategies.
Keywords: Adult; Biomarkers, Tumor; Chemotherapy, Adjuvant; Humans; Lymphocytes, Tumor-Infiltrating; Neoadjuvant Therapy; Prognosis; Prospective Studies; *Triple Negative Breast Neoplasms/drug therapy
Department(s): Medical Oncology; Laboratory Research
PubMed ID: 35353548
Publisher's Version: https://doi.org/10.1200/JCO.21.01536
Open Access at Publisher's Site: https://doi.org/10.1200/jco.21.01536
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2024-10-23 06:31:20

Last Modified: 2024-10-23 06:33:16