Immune phenotype and response to neoadjuvant systemic therapy (NAST) in triple negative breast cancer (TNBC).

Authors

null

Clinton Yam

The University of Texas MD Anderson Cancer Center, Houston, TX

Clinton Yam , Gheath Alatrash , Er-Yen Yen , Haven Garber , Anne V. Philips , Lei Huo , Fei Yang , Roland L. Bassett Jr., Xiangjie Sun , Edwin Roger Parra Cuentas , William Fraser Symmans , Sahil Seth , Jason B White , Gaiane M Rauch , Senthil Damodaran , Jennifer Keating Litton , Jennifer Ann Wargo , Gabriel N. Hortobagyi , Stacy L. Moulder , Elizabeth A. Mittendorf

Organizations

The University of Texas MD Anderson Cancer Center, Houston, TX, Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, University of Texas MD Anderson Cancer Center, Houston, TX, Brigham and Women’s Hospital, Boston, MA

Research Funding

Conquer Cancer Foundation of the American Society of Clinical Oncology
Conquer Cancer Foundation of the American Society of Clinical Oncology, MD Anderson Breast Cancer Moonshot Program

Background: In TNBC patients (pts) receiving NAST, increasing tumor infiltrating lymphocytes (TILs) is associated with higher pathologic complete response (pCR) rates. However, since the presence of TIL do not consistently predict pCR, the current study was undertaken to more fully characterize the immune cell response and its association with pCR. Methods: T cell receptor (TCR) sequencing, PD-L1 immunohistochemistry and multiplex immunofluorescence were performed on prospectively collected pre-NAST tumor samples from 98 pts with stage I-III TNBC enrolled in ARTEMIS (NCT: 02276443). TCR clonality was calculated using Shannon’s entropy. PD-L1+ was defined as ≥1% immune cell staining. Response to NAST was defined using the residual cancer burden (RCB) index. Associations between TCR clonality, immune phenotype, and response were examined with the Wilcoxon rank sum test, Spearman’s rank correlation and multivariable logistic regression using stepwise elimination (threshold p > 0.2), as appropriate. Results: The pCR rate was 39% (38/98). pCR was associated with higher TCR clonality (median = 0.2 [in pts with pCR] vs 0.1 [in pts with residual disease], p = 0.05). Notably, the association between pCR and higher TCR clonality was observed in pts with ≥5% TIL (n = 61; p = 0.05) but not in pts with < 5% TIL (n = 37; p = 0.87). Among pts with ≥5% TIL, TCR clonality emerged as the only independent predictor of response in a multivariable model of tumor immune characteristics (odds ratio/0.1 increase in TCR clonality: 3.0, p = 0.021). PD-L1+ status was associated with higher TCR clonality (median = 0.2 [in PD-L1+] vs 0.1 [in PD-L1-], p = 0.004). Higher TCR clonality was associated with higher CD3+ (rho = 0.32, p = 0.0018) and CD3+CD8+ (rho = 0.33, p = 0.0013) infiltration but lower expression of PD-1 on CD3+ (rho = -0.24, p = 0.021) and CD3+CD8+ cells (rho = -0.21, p = 0.037). Conclusions: In TNBC, a more clonal T cell population is associated with an immunologically active microenvironment (higher CD3+ and CD3/8+ T cell; lower PD-1+CD3+ and PD-1+CD3/8+ T cell; PD-L1+) and favorable response to NAST, especially in pts with ≥5% TIL, suggesting a role for deep immune phenotyping in further refining the predictive value of TILs.

Disclaimer

This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org

Abstract Details

Meeting

2020 ASCO Virtual Scientific Program

Session Type

Poster Discussion Session

Session Title

Breast Cancer—Local/Regional/Adjuvant

Track

Breast Cancer

Sub Track

Biologic Correlates

Citation

J Clin Oncol 38: 2020 (suppl; abstr 509)

DOI

10.1200/JCO.2020.38.15_suppl.509

Abstract #

509

Poster Bd #

1

Abstract Disclosures

Funded by Conquer Cancer