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William J. Gradishar, MD, FACP, FASCO
William J. Gradishar, MD, FACP, FASCO
Posted: Thursday, June 13, 2024
Roberto A. Leon-Ferre, MD, of the Mayo Clinic Comprehensive Cancer Center, Rochester, Minnesota, and colleagues observed that patients with early-stage triple-negative breast cancer who did not undergo adjuvant or neoadjuvant chemotherapy had breast cancer tissue with a higher abundance of tumor-infiltrating lymphocyte (TIL) levels. In turn, they found that higher TIL levels in breast cancer tissue may be associated with improved survival. These findings from a retrospective analysis of nearly 2,000 patients were published in JAMA.
“This is an important finding because it highlights that the abundance of TILs in breast tissue is a prognostic biomarker in people with early-stage triple-negative breast cancer, even when chemotherapy is not administered,” said Dr. Leon-Ferre in a Mayo Clinic press release. “The study’s findings may inspire future clinical trials to explore whether patients with a favorable prognosis (high TILs) can avoid intensive chemotherapy regimens.”
The pooled analysis focused on individual patient-level data from 13 participating centers in North America, Europe, and Asia. This cohort included patients diagnosed with triple-negative breast cancer between 1979 and 2017 (with follow-up until September 2021) who had surgery with or without radiotherapy and did not receive adjuvant or neoadjuvant chemotherapy.
A total of 1,966 patients were included in the study, with a median age of 56. Of them, 55% had stage I triple-negative breast cancer. The median TIL level was 15%. Overall, 416 patients (21%) had a TIL level of 50% or higher, and 1,300 (66%) had a TIL level of less than 30%.
The 5-year distant recurrence–free survival for stage I triple-negative breast cancer was 94% for patients with a TIL level of 50% or higher, compared with 78% for those with a TIL level of less than 30%. The 5-year overall survival was 95% for patients with a TIL level of 50% or higher, compared with 82% for those with a TIL level of less than 30%. At a median follow-up of 18 years, every 10% higher TIL increment was found to be independently associated with improved survival outcomes.
Disclosure: For full disclosures of the authors, visit jamanetwork.com.
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