Beyond TILs: Predictors of pathologic complete response (pCR) in triple-negative breast cancer (TNBC) patients with moderate tumor-infiltrating lymphocytes (TIL) receiving neoadjuvant therapy.

Authors

Nour Abuhadra

Nour Abuhadra

MD Anderson Hematology/Oncology Fellowship, Houston, TX

Nour Abuhadra , Kenneth R. Hess , Jennifer Keating Litton , Gaiane M Rauch , Alastair Mark Thompson , Bora Lim , Beatriz E Adrada , Elizabeth A. Mittendorf , Senthil Damodaran , Rosalind P Candelaria , Banu Arun , Wei Tse Yang , Naoto T. Ueno , Lumarie Santiago , Rashmi Krishna Murthy , Nuhad K. Ibrahim , Aysegul A. Sahin , William Fraser Symmans , Stacy L. Moulder , Lei Huo

Organizations

MD Anderson Hematology/Oncology Fellowship, Houston, TX, The University of Texas MD Anderson Cancer Center, Houston, TX, Baylor College of Medicine, Houston, TX, Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, Dana-Farber/Brigham and Women’s Cancer Center, Boston, MA, Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, The University of Texas MD Anderson Cancer Center, Houston, TX, University of Texas MD Anderson Cancer Center, Houston, TX

Research Funding

Other
Other Foundation, Other Government Agency

Background: Increased TIL in TNBC is associated with higher rates of pCR. High TIL is also associated with improved disease free survival and overall survival. The aim of this study is to identify data cut-points of pre-treatment low, moderate and high TIL count based on pCR and to identify clinical and pathological predictors of pCR in patients with moderate TIL. Methods: We evaluated the relationship between pCR and TIL in 180 patients with stage I-III TNBC enrolled in the ARTEMIS trial (NCT02276443). Recursive portioning was used to identify cut-points. Clinical and pathological variables such as age at diagnosis, stage, race, histology as well as Ki-67, vimentin, and androgen receptor (AR) by immunohistochemistry, were evaluated in pts with moderate TIL. A multivariable logistic regression model identified variables independently, significantly associated with pCR. Results: Four TIL groups were identified with pCR rates of 23%, 31%, 48% and 78% respectively (p < 0.0001) (Table A). In the two combined moderate TIL groups, 90 (97%) pts were evaluable for the multivariate model. Stage I-II disease, high Ki-67 and low AR were associated with increased probability of pCR (Table B). The multivariable logistic regression model area under the ROC curve was 0.78 (95% CI=0.68-0.88; p<0.0001). A model of computed risk score [Stage I-II (score 2)+Ki-6750% (score 1)+AR<10% (score 1)] predicted a probability of 67% for pCR when all three variables were favorable (Table). Conclusions: Four TIL groups were identified. In pts with moderate TIL levels, early stage disease, high Ki-67 and low AR were associated with increased probability of pCR with neoadjuvant therapy.

A: TIL Groups.

% TIL (Group)N#pCR (%)
< 5 (Low)6916 (23)
≥5-10 (Moderate-Low)5116 (31)
> 10-30 (Moderate-High)4220 (48)
>30 (High)1814 (78)
B: Variables Predictive of pCR
VariableOR (95% CI)p-value
Stage I-II7.12 (1.76 – 28.9)0.007
High Ki-67 (≥50%)5.32 (1.53 - 18.5)0.01
AR low (<10%)2.93 (1.02 – 8.44)0.05
C: Computed Risk Score
Computed Risk ScoreN#pCR (%)
0-2324 (12%)
32810 (36%)
43020 (67%)

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Abstract Details

Meeting

2019 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Breast Cancer—Local/Regional/Adjuvant

Track

Breast Cancer

Sub Track

Neoadjuvant Therapy

Citation

J Clin Oncol 37, 2019 (suppl; abstr 572)

DOI

10.1200/JCO.2019.37.15_suppl.572

Abstract #

572

Poster Bd #

64

Abstract Disclosures