- Title
- Tumor-infiltrating lymphocytes and prognosis: a poled individual patient analysis of early-stage triple-negative breast cancers
- Creator
- Loi, Sherene; Drubay, Damien; Gray, Robert; Munzone, Elisabetta; Lemonnier, Jerome; Sotiriou, Christos; Piccart, Martine; Kellokumpu-Lehtinen, Pirkko-Liisa; Vingiani, Andrea; Gray, Kathryn; Andre, Fabrice; Denkert, Carsten; Adams, Sylvia; Salgado, Roberto; Michiels, Stefan; Pruneri, Giancarlo; Francis, Prudence; Lacroix-Triki, Magali; Joensuu, Heikki; Dieci, Maria Vittoria; Badve, Sunil; Demaria, Sandra
- Relation
- Funding BodyNHMRCGrant Number351164
- Relation
- Journal of Clinical Oncology Vol. 37, Issue 7, p. 559-569
- Publisher Link
- http://dx.doi.org/10.1200/JCO.18.01010
- Publisher
- American Society of Clinical Oncology
- Resource Type
- journal article
- Date
- 2019
- Description
- Purpose: The aim of the current study was to conduct a pooled analysis of studies that have investigated the prognostic value of tumor-infiltrating lymphocytes (TILs) in early-stage triple negative breast cancer (TNBC). Methods: Participating studies had evaluated the percentage infiltration of stromally located TILs (sTILs) that were quantified in the same manner in patient diagnostic samples of early-stage TNBC treated with anthracycline-based chemotherapy with or without taxanes. Cox proportional hazards regression models stratified by trial were used for invasive disease-free survival (iDFS; primary end point), distant disease-free survival (D-DFS), and overall survival (OS), fitting sTILs as a continuous variable adjusted for clinicopathologic factors. Results: We collected individual data from 2,148 patients from nine studies. Average age was 50 years (range, 22 to 85 years), and 33% of patients were node negative. The average value of sTILs was 23% (standard deviation, 20%), and 77% of patients had 1% or more sTILs. sTILs were significantly lower with older age (P = .001), larger tumor size (P = .01), more nodal involvement (P = .02), and lower histologic grade (P = .001). A total of 736 iDFS and 548 D-DFS events and 533 deaths were observed. In the multivariable model, sTILs added significant independent prognostic information for all end points (likelihood ratio χ2, 48.9 iDFS; P < .001; χ2, 55.8 D-DFS; P < .001; χ2, 48.5 OS; P < .001). Each 10% increment in sTILs corresponded to an iDFS hazard ratio of 0.87 (95% CI, 0.83 to 0.91) for iDFS, 0.83 (95% CI, 0.79 to 0.88) for D-DFS, and 0.84 (95% CI, 0.79 to 0.89) for OS. In node-negative patients with sTILs ≥ 30%, 3-year iDFS was 92% (95% CI, 89% to 98%), D-DFS was 97% (95% CI, 95% to 99%), and OS was 99% (95% CI, 97% to 100%). Conclusion: This pooled data analysis confirms the strong prognostic role of sTILs in early-stage TNBC and excellent survival of patients with high sTILs after adjuvant chemotherapy and supports the integration of sTILs in a clinicopathologic prognostic model for patients with TNBC. This model can be found at www.tilsinbreastcancer.org.
- Subject
- triple negative breast cancer; breast cancer; tumor-infiltrating lymphocytes; chemotherapy; stromally located TILs
- Identifier
- http://hdl.handle.net/1959.13/1397704
- Identifier
- uon:34339
- Identifier
- ISSN:1527-7755
- Language
- eng
- Full Text
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