Chae Heejung, Yoo Changhoon, Yoon Jung-A, Lee Hee Jin, Kim Kyu-Pyo, Kim Jeong-Eun, Ahn Jin-Hee, Jung Kyung Hae, Gong Gyungyub, Kim Sung-Bae
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
J Breast Cancer. 2018 Mar;21(1):45-50. doi: 10.4048/jbc.2018.21.1.45. Epub 2018 Mar 23.
The prognosis of human epidermal growth factor receptor 2 (HER2)-positive breast cancer has markedly improved since the introduction of trastuzumab. We aimed to evaluate the association between stromal tumor-infiltrating lymphocyte (sTIL) or polymorphisms and survival among patients with metastatic HER2-positive breast cancer who were treated with trastuzumab.
A total of 56 women with recurrent or metastatic HER2-positive breast cancer who received the trastuzumab-taxane combination as first-line treatment were included in this retrospective analysis. The single-step multiplex allele-specific real-time polymerase chain reaction technique was employed for genotyping. sTILs were identified via immunohistochemical analysis of surgical (n=34, 60.7%) or biopsy specimens of metastatic lesions (n=22, 39.3%).
We classified patients based on the sTIL level (≤10% [n=44] or >10% [n=12]); high sTIL counts were more commonly observed in patients with hormone receptor-negative tumors than in those with hormone receptor-positive tumors (34.8% vs. 12.1%, =0.02). There was a significant association between high sTIL levels and longer progression-free survival in comparison to low sTIL levels (median, 28.4 months vs. 16.8 months; =0.03). With regard to the -158 genotype, patients were classified into the Phenylalanine/Phenylalanine group (23 patients, 41.1%), Phenylalanine/Valine group (23 patients, 41,1%), or Valine/Valine group (10 patients, 17.9%); these classifications were not associated with clinical outcomes.
High sTIL expression may be associated with better efficacy of trastuzumab-containing therapy in patients with metastatic HER2-positive breast cancer. However, this finding warrants further evaluation in the larger population.
自曲妥珠单抗应用以来，人表皮生长因子受体2（HER2）阳性乳腺癌的预后有了显著改善。我们旨在评估基质肿瘤浸润淋巴细胞（sTIL）或基因多态性与接受曲妥珠单抗治疗的转移性HER2阳性乳腺癌患者生存率之间的关联。
本回顾性分析纳入了56例接受曲妥珠单抗-紫杉烷联合方案作为一线治疗的复发或转移性HER2阳性乳腺癌女性患者。采用单步多重等位基因特异性实时聚合酶链反应技术进行基因分型。通过对手术标本（n = 34，60.7%）或转移病灶活检标本（n = 22，39.3%）进行免疫组织化学分析来鉴定sTIL。
我们根据sTIL水平（≤10% [n = 44] 或>10% [n = 12]）对患者进行分类；激素受体阴性肿瘤患者中高sTIL计数的观察频率高于激素受体阳性肿瘤患者（34.8% 对12.1%，P = 0.02）。与低sTIL水平相比，高sTIL水平与更长的无进展生存期之间存在显著关联（中位数，28.4个月对16.8个月；P = 0.03）。关于-158基因型，患者被分为苯丙氨酸/苯丙氨酸组（23例患者，41.1%）、苯丙氨酸/缬氨酸组（23例患者，41.1%）或缬氨酸/缬氨酸组（10例患者，17.9%）；这些分类与临床结局无关。
高sTIL表达可能与转移性HER2阳性乳腺癌患者含曲妥珠单抗治疗的更好疗效相关。然而，这一发现有待在更大规模人群中进一步评估。
