Early TNBC: high sTILs predict better survival in pooled analysis

  • Loi S & al.
  • J Clin Oncol
  • 16 Jan 2019

  • curated by Miriam Davis, PhD
  • Univadis Clinical Summaries
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Takeaway

  • Higher levels of stromal tumor-infiltrating lymphocytes (sTILs) are positive predictors for improved survival in women with early-stage triple-negative breast cancer (TNBC) undergoing anthracycline-based chemotherapy with/without taxanes.
  • In node-negative patients with high sTILs (≥30%), 3-year OS reaches 99%.

Why this matters

Study design

  • Pooled analysis of individual data from 9 studies (randomized controlled trials and retrospective cohorts) of 2148 women with TNBC.
  • sTILs were obtained at diagnosis before anthracycline-based chemotherapy±taxanes.
  • Primary outcome: invasive DFS.
  • Funding: Ligue Nationale Contre Le Cancer; International Breast Cancer Study Group.

Key results

  • 77% of patients had ≥1% sTILs; mean sTILs was 23%.
  • Median follow-up ranged from 6.58 to 7.15 years, depending on outcome.
  • Higher sTILs were associated with improved survival in multivariate analysis, with each 10% increment corresponding to a 14%-17% improvement:
    • DFS: HR, 0.86; 95% CI, 0.83-0.90.
    • Distant DFS: HR, 0.83; 95% CI, 0.78-0.87.
    • OS: HR, 0.83; 95% CI, 0.79-0.88.
  • Node-negative TNBC with ≥30% sTILs had a 3-year DFS of 92% (95% CI, 89%-98%), distant DFS of 97% (95% CI, 95%-99%), and OS of 99% (95% CI, 97%-100%).

Limitations

  • Patients treated over the last 10 years not captured.

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