Prognostic impact of high stromal tumor-infiltrating lymphocytes (sTIL) in the absence of pathologic complete response (pCR) to neoadjuvant therapy (NAT) in early stage triple negative breast cancer (TNBC).

Authors

Nour Abuhadra

Nour Abuhadra

MD Anderson Hematology/Oncology Fellowship, Houston, TX

Nour Abuhadra , Ryan Sun , Jennifer Keating Litton , Gaiane M Rauch , Alastair Mark Thompson , Bora Lim , Beatriz E Adrada , Elizabeth A. Mittendorf , Jason B White , Elizabeth Ravenberg , Senthil Damodaran , Rosalind P Candelaria , Banu Arun , Naoto T. Ueno , Lumarie Santiago , Rashmi Krishna Murthy , Nuhad K. Ibrahim , William Fraser Symmans , Stacy L. Moulder , Lei Huo

Organizations

MD Anderson Hematology/Oncology Fellowship, Houston, TX, MD Anderson Cancer Center, Houston, TX, The University of Texas MD Anderson Cancer Center, Houston, TX, Baylor College of Medicine, Houston, TX, Brigham and Women’s Hospital, Boston, MA, Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, 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
CPRIT, MD Anderson Breast Moonshots Program

Background: Pathologic complete response is an excellent surrogate for disease-free survival (DFS) and overall survival (OS) in TNBC. High sTIL is associated with improved pCR rates in TNBC. Recent data suggest that high sTIL is also associated with improved outcomes in patients who received no chemotherapy for early stage TNBC (Park, Annals of Oncology, 2019). Thus, we hypothesized that high sTIL may have prognostic impact in patients who do not achieve pCR to NAT. Methods: Pretreatment core biopsies from 182 patients with early-stage TNBC enrolled on the ARTEMIS trial (NCT02276443) were evaluated for sTIL by H&E. Patients were stratified according to sTIL (low < 30%, and high > 30%) and pCR (patients with pCR vs. no pCR). The primary outcome measure was DFS, defined from the date of diagnosis to the first local recurrence, distant metastases or death. Cox proportional hazards regression model was used. During follow-up 33 events for DFS were observed. Results: Among subjects who achieve pCR, DFS was excellent regardless of sTIL status and significantly better than those without pCR (p < 0.05). However, patients with high sTIL and no pCR demonstrated significantly worse DFS compared to all subjects having pCR (HR 0.18, 95% CI 0.04-0.76, p = 0.02). Additionally, we did not find a significant difference between high and low sTIL patients who did not achieve pCR. Conclusions: In early TNBC receiving NAT, for patients failing to achieve pCR, high sTIL was not associated with improved DFS; outcomes were comparable to those with low sTIL without pCR. Thus, high sTIL at baseline does not appear to confer an intrinsic prognostic benefit in the absence of pCR.

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 Session

Session Title

Breast Cancer—Local/Regional/Adjuvant

Track

Breast Cancer

Sub Track

Neoadjuvant Therapy

Citation

J Clin Oncol 38: 2020 (suppl; abstr 583)

DOI

10.1200/JCO.2020.38.15_suppl.583

Abstract #

583

Poster Bd #

75

Abstract Disclosures