Impact of stromal tumor-infiltrating lymphocytes (sTILs) on response to neoadjuvant chemotherapy in triple-negative early breast cancer in the WSG-ADAPT TN trial
In: Breast Cancer Research, Jg. 24 (2022), Heft 1, S. 1-13
Online
academicJournal
Zugriff:
Abstract Background Higher density of stromal tumor-infiltrating lymphocytes (sTILs) at baseline has been associated with increased rates of pathological complete response (pCR) after neoadjuvant chemotherapy (NACT) in triple-negative breast cancer (TNBC). While evidence supports favorable association of pCR with survival in TNBC, an independent impact of sTILs (after adjustment for pCR) on survival is not yet established. Moreover, the impact of sTIL dynamics during NACT on pCR and survival in TNBC is unknown. Methods The randomized WSG-ADAPT TN phase II trial compared efficacy of 12-week nab-paclitaxel with gemcitabine versus carboplatin. This preplanned translational analysis assessed impacts of sTIL measurements at baseline (sTIL-0) and after 3 weeks of chemotherapy (sTIL-3) on pCR and invasive disease-free survival (iDFS). Predictive performance of sTIL-0 and sTIL-3 for pCR was quantified by ROC analysis and logistic regression; Kaplan–Meier estimation and Cox regression (with mediation analysis) were used to determine their impact on iDFS. Results For prediction of pCR, the AUC statistics for sTIL-0 and sTIL-3 were 0.60 and 0.63, respectively, in all patients; AUC for sTIL-3 was higher in NP/G. The positive predictive value (PPV) of “lymphocyte-predominant” status (sTIL-0 ≥ 60%) at baseline was 59.3%, though only 13.0% of patients had this status. To predict non-pCR, the cut point sTIL-0 ≤ 10% yielded PPV = 69.5% while addressing 33.8% of patients. Higher sTIL levels (particularly at 3 weeks) were independently and favorably associated with better iDFS, even after adjusting for pCR. For example, the adjusted hazard ratio for 3-week sTILs ≥ 60% (vs.
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Impact of stromal tumor-infiltrating lymphocytes (sTILs) on response to neoadjuvant chemotherapy in triple-negative early breast cancer in the WSG-ADAPT TN trial
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Autor/in / Beteiligte Person: | Kolberg-Liedtke, Cornelia ; Feuerhake, Friedrich ; Garke, Madlen ; Christgen, Matthias ; Kates, Ronald ; Eva Maria Grischke ; Forstbauer, Helmut ; Braun, Michael ; Warm, Mathias ; Hackmann, John ; Uleer, Christoph ; Aktas, Bahriye ; Schumacher, Claudia ; Kuemmel, Sherko ; Wuerstlein, Rachel ; Graeser, Monika ; Nitz, Ulrike ; Kreipe, Hans ; Gluz, Oleg ; Harbeck, Nadia |
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Zeitschrift: | Breast Cancer Research, Jg. 24 (2022), Heft 1, S. 1-13 |
Veröffentlichung: | BMC, 2022 |
Medientyp: | academicJournal |
ISSN: | 1465-542X (print) |
DOI: | 10.1186/s13058-022-01552-w |
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