1. Immune Phenotype and Response to Neoadjuvant Therapy in Triple-Negative Breast Cancer
- Author
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Anne V. Philips, Jason B White, Jennifer A. Wargo, Sahil Seth, Xiangjie Sun, Senthil Damodaran, Andrew Futreal, Gabriel N. Hortobagyi, Er-Yen Yen, Clinton Yam, Baohua Sun, Gheath Alatrash, Stacy L. Moulder, Qingqing Ding, Edwin Roger Parra Cuentas, Ignacio I. Wistuba, Fei Yang, Elizabeth A. Mittendorf, Jeffrey T. Chang, Elizabeth Ravenberg, Haven R. Garber, Jennifer L. Guerriero, Bora Lim, Jennifer K. Litton, Ryan Sun, Lei Huo, Kasthuri Kannan, Naoto T. Ueno, Roland L. Bassett, Gaiane M. Rauch, and William Fraser Symmans
- Subjects
Oncology ,Cancer Research ,medicine.medical_specialty ,medicine.medical_treatment ,CD3 ,Triple Negative Breast Neoplasms ,Article ,B7-H1 Antigen ,Lymphocytes, Tumor-Infiltrating ,Immune system ,Breast cancer ,Internal medicine ,Tumor Microenvironment ,medicine ,Humans ,Neoadjuvant therapy ,Triple-negative breast cancer ,biology ,business.industry ,Odds ratio ,Prognosis ,medicine.disease ,Neoadjuvant Therapy ,Phenotype ,Nat ,biology.protein ,Immunohistochemistry ,business - Abstract
Purpose: Increasing tumor-infiltrating lymphocytes (TIL) is associated with higher rates of pathologic complete response (pCR) to neoadjuvant therapy (NAT) in patients with triple-negative breast cancer (TNBC). However, the presence of TILs does not consistently predict pCR, therefore, the current study was undertaken to more fully characterize the immune cell response and its association with pCR. Experimental Design: We obtained pretreatment core-needle biopsies from 105 patients with stage I–III TNBC enrolled in ARTEMIS (NCT02276443) who received NAT from Oct 22, 2015 through July 24, 2018. The tumor-immune microenvironment was comprehensively profiled by performing T-cell receptor (TCR) sequencing, programmed death-ligand 1 (PD-L1) IHC, multiplex immunofluorescence, and RNA sequencing on pretreatment tumor samples. The primary endpoint was pathologic response to NAT. Results: The pCR rate was 40% (42/105). Higher TCR clonality (median = 0.2 vs. 0.1, P = 0.03), PD-L1 positivity (OR: 2.91, P = 0.020), higher CD3+:CD68+ ratio (median = 14.70 vs. 8.20, P = 0.0128), and closer spatial proximity of T cells to tumor cells (median = 19.26 vs. 21.94 μm, P = 0.0169) were associated with pCR. In a multivariable model, closer spatial proximity of T cells to tumor cells and PD-L1 expression enhanced prediction of pCR when considered in conjunction with clinical stage. Conclusions: In patients receiving NAT for TNBC, deep immune profiling through detailed phenotypic characterization and spatial analysis can improve prediction of pCR in patients receiving NAT for TNBC when considered with traditional clinical parameters.
- Published
- 2021
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