Division of Breast Surgery, Saitama Cancer Center, Saitama, Japan.
Department of General Surgical Science, Gunma University Graduate School of Medicine, Gunma, Japan.
Sci Rep. 2019 Feb 7;9(1):1583. doi: 10.1038/s41598-018-38272-1.
Predictive utility of tumor-infiltrating lymphocytes (TILs) in HER2-positive breast cancer patients receiving neoadjuvant chemotherapy (NAC) with concurrent trastuzumab remains unclear. We examined TILs grades of pretreatment cancer tissue specimens and residual tumors after NAC with trastuzumab and determined the predictive utility of the TILs grade in pathological complete response (pCR) and the prognostic power of TILs in HER2-positive breast cancer. This cohort study included 128 HER2-positive breast cancer who received NAC with trastuzumab. TILs grading of the tumor stroma in pretreatment biopsy specimens and residual tumors after NAC with trastuzumab was categorized as low, intermediate, and high based on the criteria of the International Working Group. In current study, the pCR rate was 64.8%, and the Relapse-free survival (RFS) was significantly worse in the non-pCR group than in the pCR group. The pCR rate correlated with the TILs grade in pretreatment tumors. In 45 non-pCR patients, TILs grade was higher in the residual tumors than in the pretreatment tumors. The RFS was significantly better in residual tumors with high TILs grade than those with low TILs grade (p = 0.033). In conclusion, assessment of the TILs grade in residual tumors after NAC with trastuzumab might be necessary to determine patients with good prognosis among those who do not achieve pCR.
肿瘤浸润淋巴细胞（TILs）在接受曲妥珠单抗新辅助化疗（NAC）的 HER2 阳性乳腺癌患者中的预测作用尚不清楚。我们检查了 TILs 分级的预处理癌症组织标本和曲妥珠单抗 NAC 后的残留肿瘤，并确定了 TILs 分级在病理完全缓解（pCR）中的预测作用以及 TILs 在 HER2 阳性乳腺癌中的预后能力。这项队列研究包括 128 名接受曲妥珠单抗 NAC 的 HER2 阳性乳腺癌患者。根据国际工作组的标准，基于预处理活检标本和曲妥珠单抗 NAC 后残留肿瘤的肿瘤基质中 TILs 分级分为低、中和高。在本研究中，pCR 率为 64.8%，非 pCR 组的无复发生存率（RFS）明显差于 pCR 组。pCR 率与预处理肿瘤中的 TILs 分级相关。在 45 名非 pCR 患者中，残留肿瘤中的 TILs 分级高于预处理肿瘤。高 TILs 分级的残留肿瘤的 RFS 明显好于低 TILs 分级的残留肿瘤（p=0.033）。总之，评估曲妥珠单抗 NAC 后残留肿瘤中的 TILs 分级可能对于确定未达到 pCR 的患者中预后良好的患者是必要的。
