Coleman Cara, Selvakumar Tharakeswari, Thurlapati Aswani, Graf Kevin, Pavuluri Sushma, Mehrotra Shikhar, Sahin Ozgur, Sivapiragasam Abirami
Department of Hematology/Oncology, Hollings Cancer Center, Medical University of South Carolina, Charleston, SC 29425, USA.
Department of Surgery, Medical University of South Carolina, Charleston, SC 29425, USA.
Int J Mol Sci. 2025 May 1;26(9):4292. doi: 10.3390/ijms26094292.
Triple-negative breast cancer (TNBC) continues to present a therapeutic challenge due to the fact that by definition, these cancer cells lack the expression of targetable receptors. Current treatment options include cytotoxic chemotherapy, antibody-drug conjugates (ADC), and the PD-1 checkpoint inhibitor, pembrolizumab. Due to high rates of recurrence, current guidelines for early-stage TNBC recommend either multi-agent chemotherapy or chemo-immunotherapy in all patients other than those with node-negative tumors < 0.5 cm. This approach can lead to significant long-term effects for TNBC survivors, driving a growing interest in de-escalating therapy where appropriate. Tumor infiltrating lymphocytes (TILs) represent a promising prognostic and predictive biomarker for TNBC. These diverse immune cells are present in the tumor microenvironment and within the tumor itself, and multiple retrospective studies have demonstrated that a higher number of TILs in early-stage TNBC portends a favorable prognosis. Research has also explored the potential of TIL scores to predict the response to immunotherapy. However, several barriers to the widespread use of TILs in clinical practice remain, including logistical and technical challenges with the scoring of TILs and lack of prospective trials to validate the trends seen in retrospective studies. This review will present the current understanding of the role of TILs in TNBC and discuss the future directions of TIL research.
三阴性乳腺癌（TNBC）仍然是一个治疗难题，因为根据定义，这些癌细胞缺乏可靶向受体的表达。目前的治疗选择包括细胞毒性化疗、抗体药物偶联物（ADC）和PD-1检查点抑制剂帕博利珠单抗。由于复发率高，早期TNBC的现行指南建议，除肿瘤直径<0.5 cm且无淋巴结转移的患者外，所有患者均采用多药化疗或化疗免疫疗法。这种方法会给TNBC幸存者带来显著的长期影响，因此人们越来越有兴趣在适当的情况下降低治疗强度。肿瘤浸润淋巴细胞（TILs）是TNBC一种很有前景的预后和预测生物标志物。这些多样的免疫细胞存在于肿瘤微环境和肿瘤内部，多项回顾性研究表明，早期TNBC中TILs数量较多预示着预后良好。研究还探讨了TIL评分预测免疫治疗反应的潜力。然而，TILs在临床实践中广泛应用仍存在一些障碍，包括TILs评分的后勤和技术挑战，以及缺乏前瞻性试验来验证回顾性研究中发现的趋势。本综述将介绍目前对TILs在TNBC中作用的理解，并讨论TIL研究的未来方向。
