Prognostic and predictive capacity of tumor infiltrating lymphocytes in the MA.20 regional node radiotherapy trial.

IF 7.6 2区医学 Q1 ONCOLOGY

NPJ Breast Cancer Pub Date : 2025-08-29 DOI:10.1038/s41523-025-00821-z

N Riaz, B E Chen, A Bane, D Gao, E S Stovgaard, Z Kos, S C Leung, E Shenasa, W Parulekar, S Chambers, T O Nielsen, T J Whelan

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Abstract

Prognostic and predictive value of immune infiltrates in the context of regional nodal radiation (RNI) for breast cancer has not been assessed. Stromal tumor infiltrating lymphocytes (sTILs) were assessed on scanned images of hematoxylin and eosin (H&E) stained sections and by CD8 immunohistochemistry on tissue microarrays available from the MA.20 trial. Cox proportional modelling was used, and hazard ratios (HR) with 95% confidence intervals (CI) are reported for primary and secondary endpoints. Predictive value was assessed by an interaction test. H&E sTILs (continuous parameter) were prognostic for distant-DFS (HR 0.99, 95% CI 0.98-1.00, P = 0.04). CD8+sTILs were associated with significantly improved disease-free survival (DFS) (HR 0.99, 95% CI 0.98-1.00, P = 0.02) and distant-DFS (HR 0.98, 95% CI 0.97-0.99, P = 0.0002). CD8+sTILs was predictive of benefit from RNI for distant-DFS (continuous variable: HR 0.98, 95% CI 0.96-1.00, P_{(interaction)} = 0.04; exploratory categorical variable: CD8+ sTILs < 44, HR = 0.83; 95% CI 0.57-1.21, and CD8+ sTILs ≥ 44; HR 0.09; 95% CI 0.01-0.74, P_{(interaction)} = 0.04). In MA.20 breast cancer patients, pre-treatment sTILs were prognostic for DFS (CD8+sTILs) and distant-DFS. CD8+sTILs also appeared to be predictive for the effectiveness of RNI on distant-DFS, suggesting that immune mechanisms may in part be responsible and merits further investigation.

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肿瘤浸润淋巴细胞在MA.20区域淋巴结放疗试验中的预后和预测能力。

区域性淋巴结放射（RNI）下免疫浸润对乳腺癌的预后和预测价值尚未得到评估。通过苏木精和伊红（H&E）染色切片的扫描图像和MA.20试验中组织微阵列的CD8免疫组化，评估基质肿瘤浸润淋巴细胞（stil）。采用Cox比例模型，报告了主要终点和次要终点的风险比（HR）和95%置信区间（CI）。通过交互作用测试评估预测价值。H&E stil（连续参数）是远处dfs的预后指标（HR 0.99, 95% CI 0.98-1.00, P = 0.04）。CD8+ stil与显著改善无病生存（DFS）（HR 0.99, 95% CI 0.98-1.00, P = 0.02）和远端无病生存（HR 0.98, 95% CI 0.97-0.99, P = 0.0002）相关。CD8+sTILs可预测远端dfs的RNI获益(连续变量：HR 0.98, 95% CI 0.96-1.00， P（相互作用）= 0.04；探索性分类变量：CD8+ sTILs（交互作用）= 0.04。在MA.20乳腺癌患者中，治疗前stil是DFS （CD8+ stil）和远处DFS的预后因素。CD8+ stil似乎也能预测RNI对远处dfs的有效性，这表明免疫机制可能是部分原因，值得进一步研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

NPJ Breast Cancer Medicine-Pharmacology (medical)

CiteScore

10.10

自引率

1.70%

发文量

122

审稿时长

9 weeks

期刊介绍： npj Breast Cancer publishes original research articles, reviews, brief correspondence, meeting reports, editorial summaries and hypothesis generating observations which could be unexplained or preliminary findings from experiments, novel ideas, or the framing of new questions that need to be solved. Featured topics of the journal include imaging, immunotherapy, molecular classification of disease, mechanism-based therapies largely targeting signal transduction pathways, carcinogenesis including hereditary susceptibility and molecular epidemiology, survivorship issues including long-term toxicities of treatment and secondary neoplasm occurrence, the biophysics of cancer, mechanisms of metastasis and their perturbation, and studies of the tumor microenvironment.