AI Article Synopsis
- Stromal tumor-infiltrating lymphocytes (TILs) are important independent prognostic factors for untreated early-stage triple-negative breast cancer (TNBC), alongside other immune markers like CD8, PD-L1, and tertiary lymphoid structures (TLS).
- A study of 125 TNBC patients found that including CD8 and PD-L1 in prognostic models significantly improved predictions for patient outcomes compared to using TILs alone.
- High levels of CD8 were linked to better prognosis, while PD-L1 positivity indicated worse outcomes, suggesting that these biomarkers could refine prognostic assessments and guide future clinical trials in TNBC treatment.
Article Abstract
Purpose: Stromal tumor-infiltrating lymphocytes (TILs) are independent prognostic factors in systemically untreated early-stage triple-negative breast cancer (TNBC). Other immune biomarkers including CD8, CD20, programmed cell death-ligand 1 (PD-L1), and tertiary lymphoid structures (TLS) are also reported to be associated with prognosis. However, whether combining other immune biomarkers with TILs would allow for further prognostic stratification is unknown.
Methods: We retrospectively analyzed 125 patients with early-stage TNBC not receiving perioperative chemotherapy. Stromal TILs and TLS were evaluated on hematoxylin-eosin slides. PD-L1 expression was evaluated using the SP142 assay. CD8 and CD20 were assessed by immunohistochemistry and counted by digital pathology.
Results: Immune biomarker levels were positively correlated (p < 0.001). Adding CD8 and PD-L1 to multivariable analysis including clinicopathological factors (stage and histological grade) and TILs significantly improved the prognostic model (likelihood ratio χ = 9.24, p = 0.01). In Cox regression analysis, high CD8 was significantly associated with better prognosis [hazard ratio (HR) 0.69, 95% confidence interval (CI) 0.48-0.98, p = 0.04], and PD-L1 positivity was significantly associated with worse prognosis (HR 4.33, 95%CI 1.57-11.99, p = 0.005). Patients with high CD8/PD-L1 (-) tumors had the most favorable prognosis [5 year invasive disease-free survival (iDFS), 100%], while patients with low CD8/PD-L1( +) tumors had the worst prognosis (5 year iDFS, 33.3%).
Conclusion: CD8 and PD-L1 levels add prognostic information beyond TILs for early-stage TNBC not receiving perioperative chemotherapy. CD8-positive T cells and PD-L1 may be useful for prognostic stratification and in designing future clinical trials of TNBC.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9823028 | PMC |
| http://dx.doi.org/10.1007/s10549-022-06787-x | DOI Listing |
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