Prognostic Value of Stromal Tumor-Infiltrating Lymphocytes in Young, Node-Negative, Triple-Negative Breast Cancer Patients Who Did Not Receive (neo)Adjuvant Systemic Therapy
In: Journal of Clinical Oncology, Jg. 40 (2022-07-20), Heft 21, S. 2361-2375
Online
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Zugriff:
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-naïve, 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 (χ2 = 46.7, P < .001). CONCLUSION Chemotherapy-naïve, 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.
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Prognostic Value of Stromal Tumor-Infiltrating Lymphocytes in Young, Node-Negative, Triple-Negative Breast Cancer Patients Who Did Not Receive (neo)Adjuvant Systemic Therapy
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Autor/in / Beteiligte Person: | Vincent M.T. de Jong ; Wang, Yuwei ; Natalie D. ter Hoeve ; Opdam, Mark ; Stathonikos, Nikolas ; Jóźwiak, Katarzyna ; Hauptmann, Michael ; Cornelissen, Sten ; Vreuls, Willem ; Rosenberg, Efraim H. ; Koop, Esther A. ; Varga, Zsuzsanna ; Carolien H.M. van Deurzen ; Mooyaart, Antien L. ; Córdoba, Alicia ; Groen, Emma J. ; Bart, Joost ; Willems, Stefan M. ; Zolota, Vasiliki ; Wesseling, Jelle ; Sapino, Anna ; Chmielik, Ewa ; Ryska, Ales ; Broeks, Annegien ; Voogd, Adri C. ; Loi, Sherene ; Michiels, Stefan ; Sonke, Gabe S. ; Elsken van der Wall ; Siesling, Sabine ; Paul J. van Diest ; Schmidt, Marjanka K. ; Kok, Marleen ; Gwen M.H.E. Dackus ; Salgado, Roberto ; Linn, Sabine C. ; RS: GROW - R1 - Prevention ; RS: CAPHRI - R5 - Optimising Patient Care ; Epidemiologie ; Centre, TechMed ; Health Technology & Services Research ; Targeted Gynaecologic Oncology (TARGON) ; Damage and Repair in Cancer Development and Cancer Treatment (DARE) ; Guided Treatment in Optimal Selected Cancer Patients (GUTS) ; Pathology |
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Zeitschrift: | Journal of Clinical Oncology, Jg. 40 (2022-07-20), Heft 21, S. 2361-2375 |
Veröffentlichung: | AMER SOC CLINICAL ONCOLOGY, 2022 |
Medientyp: | unknown |
ISSN: | 1527-7755 (print) ; 0732-183X (print) |
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