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Breast Cancer Res. 2017 Aug 7;19(1):91. doi: 10.1186/s13058-017-0884-8.

Effect of neoadjuvant chemotherapy on tumor-infiltrating lymphocytes and PD-L1 expression in breast cancer and its clinical significance.

Author information

1
Department of Pathology, Yale University School of Medicine, 310 Cedar St, PO Box 208023, New Haven, CT, 06520-8023, USA. vasiliki.pelekanou@yale.edu.
2
Department of Pathology, Yale University School of Medicine, 310 Cedar St, PO Box 208023, New Haven, CT, 06520-8023, USA.
3
Department of Medical Oncology, Yale University School of Medicine, New Haven, CT, USA.
4
Department of Surgery, Yale University School of Medicine, New Haven, CT, USA.

Abstract

BACKGROUND:

The effects of neoadjuvant chemotherapy on immune markers remain largely unknown. The specific aim of this study was to assess stromal tumor-infiltrating lymphocytes (TILs) and programmed death ligand 1 (PD-L1) protein expression in a cohort of breast cancer patients treated with neoadjuvant chemotherapy.

METHODS:

Using quantitative immunofluorescence, we investigated stromal TILs and PD-L1 protein expression in pre-treatment and residual breast cancer tissue from a Yale Cancer Center patient cohort of 58 patients diagnosed with breast cancer from 2003 to 2009 and treated with neoadjuvant chemotherapy. We compared the TIL count and PD-L1 status in paired pre-treatment and residual cancer tissues and correlated changes and baseline levels with survival.

RESULTS:

Of the 58 patients, 46 (79.3%) had hormone-positive and 34 (58.6%) had node-positive breast cancer. Eighty-six percent of residual cancer tissues had TIL infiltration and 17% had PD-L1 expression. There was a trend for higher TIL counts in postchemotherapy compared to prechemotherapy samples (p = 0.09). Increase in TIL count was associated with longer 5-year recurrence-free survival (p = 0.02, HR = 3.9, 95% CI = 1.179-15.39). PD-L1 expression (both stromal and tumor cells) was significantly lower in post-treatment samples (p = 0.001). Change in PD-L1 expression after therapy or TILs and PD-L1 expression in the posttreatment samples did not correlate with survival.

CONCLUSIONS:

Increase in stromal TILs in residual cancer compared to pretreatment tissue is associated with improved recurrence-free survival. Despite a trend for increasing TIL counts, PD-L1 expression decreased in residual disease compared to pretreatment samples.

KEYWORDS:

Breast cancer; Neoadjuvant treatment; Programmed death ligand 1; Tumor infiltrating lymphocytes

PMID:
28784153
PMCID:
PMC5547502
DOI:
10.1186/s13058-017-0884-8
[Indexed for MEDLINE]
Free PMC Article

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