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Tumour-infiltrating lymphocytes and response to neoadjuvant letrozole in patients with early oestrogen receptor-positive breast cancer: analysis from a nationwide phase II DBCG trial.


ABSTRACT: BACKGROUND:The presence of tumour-infiltrating lymphocytes (TILs) is associated with response to neoadjuvant chemotherapy among patients with triple-negative and HER2-positive breast cancer. However, the significance of TILs is less clear in luminal breast cancer. Here, we in postmenopausal patients with primary oestrogen receptor-positive (ER+), HER2 normal, operable breast cancer assessed the importance of inducing TILs during 4 months of letrozole on response in a neoadjuvant phase II study. METHODS:Participants were postmenopausal women with ER+, HER2 normal operable breast cancer assigned to 4 months of neoadjuvant letrozole. Pretreatment core biopsies and surgical specimens were assessed centrally for the percentage of TILs on haematoxylin and eosin-stained slides according to the International Immuno-Oncology Biomarker Working Group on Breast Cancer guidelines. Pathological response was assessed by the Residual Cancer Burden (RCB) index and a modified Miller-Payne grading system and was analysed according to change in TILs. RESULTS:Tumour specimens were available from 106 of the 112 patients treated per protocol. TIL concentration increased with mean 6.8 percentage point (p < 0.0001) during treatment (range -?39 to 60). An increase in TILs was significantly associated with pathological response with OR?=?0.71 (95% CI 0.53-0.96; p =?0.02) per 10% absolute increase for pathological response and correspondingly OR?=?0.56 (95% CI 0.40-0.78; p =?0.0007) for lower RCB index per 10% increase. CONCLUSION:Increasing TILs during letrozole was significantly associated with a poor treatment response. An increase in TILs during endocrine therapy might imply immunogenicity, and these patients could be targetable by immunotherapy. TRIAL REGISTRATION:ClinicalTrials.govNCT00908531, registered 27 May 2009.

SUBMITTER: Skriver SK 

PROVIDER: S-EPMC7222485 | biostudies-literature | 2020 May

REPOSITORIES: biostudies-literature

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Tumour-infiltrating lymphocytes and response to neoadjuvant letrozole in patients with early oestrogen receptor-positive breast cancer: analysis from a nationwide phase II DBCG trial.

Skriver Signe Korsgaard SK   Jensen Maj-Britt MB   Knoop Ann Soegaard AS   Ejlertsen Bent B   Laenkholm Anne-Vibeke AV  

Breast cancer research : BCR 20200514 1


<h4>Background</h4>The presence of tumour-infiltrating lymphocytes (TILs) is associated with response to neoadjuvant chemotherapy among patients with triple-negative and HER2-positive breast cancer. However, the significance of TILs is less clear in luminal breast cancer. Here, we in postmenopausal patients with primary oestrogen receptor-positive (ER+), HER2 normal, operable breast cancer assessed the importance of inducing TILs during 4 months of letrozole on response in a neoadjuvant phase II  ...[more]

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