Abstract
Background. The role of tumor-infiltrating lymphocytes (TILs) in breastcancer (BC) is still an issue for clinical research.Toward this end, a sensitivity analysis of neoadjuvant and adjuvant randomized clinical trials was performed according to disease subtypes. Methods. Pathological complete responses (pCRs) after neoadjuvant treatment according to the presence or absence of lymphocyte-predominant BC (LPBC) were extracted and cumulated as odds ratios (ORs) by adopting a random-effects model by subtype. Overall survival hazard ratios as a function of 10% incremental values of stromal TILs (sTILs) in adjuvant trials were extracted. The interaction test was adopted to determine the differential effect according to the subtype. Results. Eight trials (5,514 patients) were identified. With regard to neoadjuvant setting (4 studies), a significant interaction (p <.0001) according to LPBC was found. The presence of LPBC was associated with a 29.5% increase in pCR rate compared with non-LPBC (p <.0001). The pCR rate was significantly higher in patients with LPBC in triple-negative BC (TNBC) and HER2-positive BC settings, with an absolute difference of 15.7% (95% confidence interval [CI], 4.9%–26.2%) and 33.3% (95% CI, 23.6%–42.7%), respectively. With respect to the adjuvant setting (4 studies), a significant interaction (p,.0001) according to sTILs was found. A survival benefit was more likely to be determined for HER2-positive BC (p = .025) and TNBC (p <.0001), with no statistically significant difference for estrogen receptor-positive/HER2- negative disease. Conclusion. Despite the retrospective nature of this analysis, the presence of TILs may represent a robust predictive and prognostic marker for BC, particularly for TNBC and HER2- positive disease.
| Original language | English |
|---|---|
| Pages (from-to) | 283-291 |
| Number of pages | 9 |
| Journal | The oncologist |
| Volume | 21 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Feb 10 2016 |
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Keywords
- Adjuvant
- Breast cancer
- Neoadjuvant
- Prognosis
- Sensitivity analysis
- Tumor-infiltrating lymphocytes
ASJC Scopus subject areas
- Cancer Research
- Oncology
Cite this
Predictive and prognostic role of tumor-infiltrating lymphocytes for early breast cancer according to disease subtypes : Sensitivity analysis of randomized trials in adjuvant and neoadjuvant setting. / Carbognin, Luisa; Pilotto, Sara; Nortilli, Rolando; Brunelli, Matteo; Nottegar, Alessia; Sperduti, Isabella; Giannarelli, Diana; Bria, Emilio; Tortora, Giampaolo.
In: The oncologist, Vol. 21, No. 3, 10.02.2016, p. 283-291.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Predictive and prognostic role of tumor-infiltrating lymphocytes for early breast cancer according to disease subtypes
T2 - Sensitivity analysis of randomized trials in adjuvant and neoadjuvant setting
AU - Carbognin, Luisa
AU - Pilotto, Sara
AU - Nortilli, Rolando
AU - Brunelli, Matteo
AU - Nottegar, Alessia
AU - Sperduti, Isabella
AU - Giannarelli, Diana
AU - Bria, Emilio
AU - Tortora, Giampaolo
PY - 2016/2/10
Y1 - 2016/2/10
N2 - Background. The role of tumor-infiltrating lymphocytes (TILs) in breastcancer (BC) is still an issue for clinical research.Toward this end, a sensitivity analysis of neoadjuvant and adjuvant randomized clinical trials was performed according to disease subtypes. Methods. Pathological complete responses (pCRs) after neoadjuvant treatment according to the presence or absence of lymphocyte-predominant BC (LPBC) were extracted and cumulated as odds ratios (ORs) by adopting a random-effects model by subtype. Overall survival hazard ratios as a function of 10% incremental values of stromal TILs (sTILs) in adjuvant trials were extracted. The interaction test was adopted to determine the differential effect according to the subtype. Results. Eight trials (5,514 patients) were identified. With regard to neoadjuvant setting (4 studies), a significant interaction (p <.0001) according to LPBC was found. The presence of LPBC was associated with a 29.5% increase in pCR rate compared with non-LPBC (p <.0001). The pCR rate was significantly higher in patients with LPBC in triple-negative BC (TNBC) and HER2-positive BC settings, with an absolute difference of 15.7% (95% confidence interval [CI], 4.9%–26.2%) and 33.3% (95% CI, 23.6%–42.7%), respectively. With respect to the adjuvant setting (4 studies), a significant interaction (p,.0001) according to sTILs was found. A survival benefit was more likely to be determined for HER2-positive BC (p = .025) and TNBC (p <.0001), with no statistically significant difference for estrogen receptor-positive/HER2- negative disease. Conclusion. Despite the retrospective nature of this analysis, the presence of TILs may represent a robust predictive and prognostic marker for BC, particularly for TNBC and HER2- positive disease.
AB - Background. The role of tumor-infiltrating lymphocytes (TILs) in breastcancer (BC) is still an issue for clinical research.Toward this end, a sensitivity analysis of neoadjuvant and adjuvant randomized clinical trials was performed according to disease subtypes. Methods. Pathological complete responses (pCRs) after neoadjuvant treatment according to the presence or absence of lymphocyte-predominant BC (LPBC) were extracted and cumulated as odds ratios (ORs) by adopting a random-effects model by subtype. Overall survival hazard ratios as a function of 10% incremental values of stromal TILs (sTILs) in adjuvant trials were extracted. The interaction test was adopted to determine the differential effect according to the subtype. Results. Eight trials (5,514 patients) were identified. With regard to neoadjuvant setting (4 studies), a significant interaction (p <.0001) according to LPBC was found. The presence of LPBC was associated with a 29.5% increase in pCR rate compared with non-LPBC (p <.0001). The pCR rate was significantly higher in patients with LPBC in triple-negative BC (TNBC) and HER2-positive BC settings, with an absolute difference of 15.7% (95% confidence interval [CI], 4.9%–26.2%) and 33.3% (95% CI, 23.6%–42.7%), respectively. With respect to the adjuvant setting (4 studies), a significant interaction (p,.0001) according to sTILs was found. A survival benefit was more likely to be determined for HER2-positive BC (p = .025) and TNBC (p <.0001), with no statistically significant difference for estrogen receptor-positive/HER2- negative disease. Conclusion. Despite the retrospective nature of this analysis, the presence of TILs may represent a robust predictive and prognostic marker for BC, particularly for TNBC and HER2- positive disease.
KW - Adjuvant
KW - Breast cancer
KW - Neoadjuvant
KW - Prognosis
KW - Sensitivity analysis
KW - Tumor-infiltrating lymphocytes
UR - http://www.scopus.com/inward/record.url?scp=84960503302&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84960503302&partnerID=8YFLogxK
U2 - 10.1634/theoncologist.2015-0307
DO - 10.1634/theoncologist.2015-0307
M3 - Article
AN - SCOPUS:84960503302
VL - 21
SP - 283
EP - 291
JO - Oncologist
JF - Oncologist
SN - 1083-7159
IS - 3
ER -