医学
肿瘤科
内科学
危险系数
乳腺癌
肿瘤浸润淋巴细胞
三阴性乳腺癌
化疗
蒽环类
队列
阶段(地层学)
癌症
置信区间
免疫疗法
生物
古生物学
作者
Leonora W. de Boo,Ashley Cimino‐Mathews,Yoni Lubeck,Antonios Daletzakis,Mark Opdam,Joyce Sanders,Erik Hooijberg,Annelot van Rossum,Zuzana Loncová,Dietmar Rieder,Zlatko Trajanoski,Marieke A. Vollebergh,Marcelo Sobral-Leite,Koen Van de Vijver,Annegien Broeks,R Wiel,Harm van Tinteren,Sabine C. Linn,Hugo M. Horlings,Marleen Kok
标识
DOI:10.1016/j.ejca.2019.12.003
摘要
The prognostic value of tumour-infiltrating lymphocytes (TILs) differs by breast cancer (BC) subtype. The aim of this study was to evaluate TILs in stage III BC in the context of BRCA1/2-like phenotypes and association with outcome and benefit of intensified platinum-based chemotherapy.Patients participated in a randomised controlled trial of adjuvant intensified platinum-based chemotherapy versus conventional anthracycline-based chemotherapy carried out between 1993 and 1999 in stage III BC. Stromal TILs were scored according to International guidelines in these human epidermal growth factor receptor 2 (HER2)-negative tumours. BRCA-profiles were determined using Comparative Genomic Hybridization.TIL levels were evaluated in 248 BCs. High TILs were associated with Triple Negative BC (TNBC). BRCA-like tumours harboured higher TILs compared to non-BRCA-like tumours (median TILs of 20% versus 10%, p < 0.01). TIL levels in BRCA1-like tumours were higher compared to BRCA2-like tumours (median TILs of 20% versus 10%, p < 0.001). These correlations remained significant within the oestrogen (ER)-positive subgroup, however not within the TNBC subgroup. In this stage III BC cohort, high TIL level was associated with favourable outcome (TILs per 10% increment, recurrence-free survival (RFS): multivariate hazard ratio (HR) 0.82, 95% confidence interval (CI) 0.71-0.94, p = 0.01; overall survival (OS): multivariate HR 0.80, 95% CI 0.68-0.94, p = 0.01). There was no significant interaction between TILs and benefit of intensified platinum-based chemotherapy.In this high-risk breast cancer cohort, high TILs were associated with TNBC and BRCA1-like status. Within the ER-positive subgroup, TIL levels were higher in BRCA1-like compared to BRCA2-like tumours. When adjusted for clinical characteristics, TILs were significantly associated with a more favourable outcome in stage III BC patients.
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