A gene signature to predict high tumor-infiltrating lymphocytes after neoadjuvant chemotherapy and outcome in patients with triple-negative breast cancer

C. Criscitiello, M. A. Bayar, G. Curigliano, F. W. Symmans, C. Desmedt, H. Bonnefoi, B. Sinn, G. Pruneri, C. Vicier, J. Y. Pierga, C. Denkert, S. Loibl, C. Sotiriou, S. Michiels, F. André

Research output: Contribution to journalArticlepeer-review

Abstract

Background: In patients with triple-negative breast cancer (TNBC), the extent of tumor-infiltrating lymphocytes (TILs) in the residual disease after neoadjuvant chemotherapy (NACT) is associated with better prognosis. Our objective was to develop a gene signature frompretreatment samples to predict the extent of TILs after NACT and then to test its prognostic value on survival. Patients and methods: Using 99 pretreatment samples, we generated a four-gene signature associated with high post-NACT TILs. Prognostic value of the signature on distant relapse-free survival (DRFS) was first assessed on the training set (n=99) and then on an independent validation set (n=115). Results: A four-gene signature combining the expression levels of HLF, CXCL13, SULT1E1, and GBP1 was developed in baseline samples to predict the extent of lymphocytic infiltration after NACT. In a multivariate analysis performed on the training set, this signature was associated with DRFS [hazard ratio (HR): 0.28, for a one-unit increase in the value of the four-gene signature, 95% confidence interval (CI): 0.13-0.63)]. In a multivariate analysis performed on an independent validation set, the four-gene signature was significantly associated with DRFS (HR: 0.17, 95% CI: 0.06-0.43). The four-gene signature added significant prognostic information when compared with the clinicopathologic pretreatment model (likelihood ratio test in the training set P=0.004 and in the validation set P=0.002). Conclusions: A four-gene signature predicts high levels of TILs after anthracycline-containing NACT and outcome in patients with TNBC and adds prognostic information to a clinicopathological model at diagnosis.

Original languageEnglish
Article numbermdx691
Pages (from-to)162-169
Number of pages8
JournalAnnals of Oncology
Volume29
Issue number1
DOIs
Publication statusPublished - Jan 1 2018

Keywords

  • Breast cancer
  • Gene signature
  • Neoadjuvant therapy
  • Residual disease
  • Tumor-infiltrating lymphocytes

ASJC Scopus subject areas

  • Hematology
  • Oncology

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