Back to Search
Start Over
Immune characterization of breast cancer metastases: prognostic implications
- Source :
- Breast Cancer Research, Vol 20, Iss 1, Pp 1-10 (2018), Breast Cancer Research : BCR
- Publication Year :
- 2018
- Publisher :
- Springer Science and Business Media LLC, 2018.
-
Abstract
- Background Tumor-infiltrating lymphocytes (TILs) evaluated in primary breast cancer (BC) convey prognostic information. Limited data in the metastatic setting are available. Methods Secondary lesions from 94 BC patients, 43 triple-negative (TN) and 51 HER2-positive, were evaluated for TILs and expression of CD8, FOXP3, and PD-L1 by immunohistochemistry. Results TILs levels on metastasis were generally low (median 5%) and did not differ between TN and HER2+ tumors. Younger patients showed significantly lower TILs (p = 0.002). In HER2+ patients, TILs were higher in lung metastases as compared to other sites (p = 0.038). TILs composition was different across metastatic sites: skin metastases presented higher FOXP3 (p = 0.002) and lower CD8/FOXP3 ratio (p = 0.032). Patients treated for metastatic BC prior to biopsy had lower CD8 (overall: p = 0.005, HER2+: p = 0.011, TN: p = 0.075). In TN patients, median overall survival (OS) was 11.8 and 62.9 months for patients with low and high TILs, respectively (HR 0.29, 95%CI 0.11–0.76, log-rank p = 0.008). CD8/FOXP3 ratio was also prognostic in TN patients (median OS 8.0, 13.2, and 54.0 months in 1st, 2nd and 3th tertile, log-rank p = 0.019). Both TILs and CD8/FOXP3 ratio were independent factors at multivariate analysis. Counterintuitively, in HER2+ BC, low TILs tumors showed better prognosis (median OS 53.7 vs 39.9 months in TILs low and TILs high, not statistically significant). Conclusions Our findings indicate the relevance of TILs as prognostic biomarker for TNBC even in the advanced setting and provide novel hypothesis-generating data on potential sources of immune heterogeneity of metastatic BC. Electronic supplementary material The online version of this article (10.1186/s13058-018-1003-1) contains supplementary material, which is available to authorized users.
- Subjects :
- 0301 basic medicine
Oncology
Cancer Research
Receptor, ErbB-2
Biopsy
Triple Negative Breast Neoplasms
CD8-Positive T-Lymphocytes
B7-H1 Antigen
Tumor-infiltrating lymphocytes
Metastasis
0302 clinical medicine
Surgical oncology
Neoplasm Metastasis
biology
medicine.diagnostic_test
Forkhead Transcription Factors
hemic and immune systems
Middle Aged
Prognosis
Metastatic breast cancer
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Gene Expression Regulation, Neoplastic
030220 oncology & carcinogenesis
Immunohistochemistry
Female
HER2
PD-L1
Triple negative
Research Article
Adult
medicine.medical_specialty
Breast Neoplasms
chemical and pharmacologic phenomena
lcsh:RC254-282
Disease-Free Survival
03 medical and health sciences
Lymphocytes, Tumor-Infiltrating
Breast cancer
Internal medicine
medicine
Humans
Aged
business.industry
medicine.disease
030104 developmental biology
biology.protein
business
Subjects
Details
- ISSN :
- 1465542X
- Volume :
- 20
- Database :
- OpenAIRE
- Journal :
- Breast Cancer Research
- Accession number :
- edsair.doi.dedup.....decfbea628a77cd0ce9634c1f9d8e3e2