PMID- 26865589
OWN - NLM
STAT- MEDLINE
DCOM- 20161230
LR  - 20181113
IS  - 1549-490X (Electronic)
IS  - 1083-7159 (Print)
IS  - 1083-7159 (Linking)
VI  - 21
IP  - 3
DP  - 2016 Mar
TI  - Predictive and Prognostic Role of Tumor-Infiltrating Lymphocytes for Early Breast 
      Cancer According to Disease Subtypes: Sensitivity Analysis of Randomized Trials 
      in Adjuvant and Neoadjuvant Setting.
PG  - 283-91
LID - 10.1634/theoncologist.2015-0307 [doi]
AB  - BACKGROUND: The role of tumor-infiltrating lymphocytes (TILs) in breast cancer 
      (BC) is still an issue for clinical research. Toward this end, a sensitivity 
      analysis of neoadjuvant and adjuvant randomized clinical trials was performed 
      according to disease subtypes. METHODS: Pathological complete responses (pCRs) 
      after neoadjuvant treatment according to the presence or absence of 
      lymphocyte-predominant BC (LPBC) were extracted and cumulated as odds ratios 
      (ORs) by adopting a random-effects model by subtype. Overall survival hazard 
      ratios as a function of 10% incremental values of stromal TILs (sTILs) in 
      adjuvant trials were extracted. The interaction test was adopted to determine the 
      differential effect according to the subtype. RESULTS: Eight trials (5,514 
      patients) were identified. With regard to neoadjuvant setting (4 studies), a 
      significant interaction (p < .0001) according to LPBC was found. The presence of 
      LPBC was associated with a 29.5% increase in pCR rate compared with non-LPBC (p < 
      .0001). The pCR rate was significantly higher in patients with LPBC in 
      triple-negative BC (TNBC) and HER2-positive BC settings, with an absolute 
      difference of 15.7% (95% confidence interval [CI], 4.9%-26.2%) and 33.3% (95% CI, 
      23.6%-42.7%), respectively. With respect to the adjuvant setting (4 studies), a 
      significant interaction (p < .0001) according to sTILs was found. A survival 
      benefit was more likely to be determined for HER2-positive BC (p = .025) and TNBC 
      (p < .0001), with no statistically significant difference for estrogen 
      receptor-positive/HER2-negative disease. CONCLUSION: Despite the retrospective 
      nature of this analysis, the presence of TILs may represent a robust predictive 
      and prognostic marker for BC, particularly for TNBC and HER2-positive disease.
CI  - (c)AlphaMed Press.
FAU - Carbognin, Luisa
AU  - Carbognin L
AD  - Medical Oncology, University of Verona, Azienda Ospedaliera Universitaria 
      Integrata, Verona, Italy.
FAU - Pilotto, Sara
AU  - Pilotto S
AD  - Medical Oncology, University of Verona, Azienda Ospedaliera Universitaria 
      Integrata, Verona, Italy.
FAU - Nortilli, Rolando
AU  - Nortilli R
AD  - Medical Oncology, University of Verona, Azienda Ospedaliera Universitaria 
      Integrata, Verona, Italy.
FAU - Brunelli, Matteo
AU  - Brunelli M
AD  - Department of Pathology and Diagnostics, University of Verona, Azienda 
      Ospedaliera Universitaria Integrata, Verona, Italy.
FAU - Nottegar, Alessia
AU  - Nottegar A
AD  - Department of Pathology and Diagnostics, University of Verona, Azienda 
      Ospedaliera Universitaria Integrata, Verona, Italy.
FAU - Sperduti, Isabella
AU  - Sperduti I
AD  - Biostatistics, Regina Elena National Cancer Institute, Roma, Italy.
FAU - Giannarelli, Diana
AU  - Giannarelli D
AD  - Biostatistics, Regina Elena National Cancer Institute, Roma, Italy.
FAU - Bria, Emilio
AU  - Bria E
AD  - Medical Oncology, University of Verona, Azienda Ospedaliera Universitaria 
      Integrata, Verona, Italy emilio.bria@univr.it.
FAU - Tortora, Giampaolo
AU  - Tortora G
AD  - Medical Oncology, University of Verona, Azienda Ospedaliera Universitaria 
      Integrata, Verona, Italy.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20160210
PL  - England
TA  - Oncologist
JT  - The oncologist
JID - 9607837
RN  - 0 (Biomarkers, Tumor)
SB  - IM
MH  - Antineoplastic Combined Chemotherapy Protocols/therapeutic use
MH  - Biomarkers, Tumor/*immunology
MH  - *Chemotherapy, Adjuvant
MH  - Disease-Free Survival
MH  - Female
MH  - Humans
MH  - Lymphocytes, Tumor-Infiltrating/*immunology
MH  - *Neoadjuvant Therapy
MH  - Randomized Controlled Trials as Topic
MH  - Retrospective Studies
MH  - Treatment Outcome
MH  - Triple Negative Breast Neoplasms/*drug therapy/immunology/*pathology
PMC - PMC4786352
OTO - NOTNLM
OT  - Adjuvant
OT  - Breast cancer
OT  - Neoadjuvant
OT  - Prognosis
OT  - Sensitivity analysis
OT  - Tumor-infiltrating lymphocytes
COIS- Disclosures of potential conflicts of interest may be found at the end of this 
      article.
EDAT- 2016/02/13 06:00
MHDA- 2016/12/31 06:00
PMCR- 2017/03/01
CRDT- 2016/02/12 06:00
PHST- 2015/08/04 00:00 [received]
PHST- 2015/12/16 00:00 [accepted]
PHST- 2017/03/01 00:00 [pmc-release]
PHST- 2016/02/12 06:00 [entrez]
PHST- 2016/02/13 06:00 [pubmed]
PHST- 2016/12/31 06:00 [medline]
AID - theoncologist.2015-0307 [pii]
AID - T15307 [pii]
AID - 10.1634/theoncologist.2015-0307 [doi]
PST - ppublish
SO  - Oncologist. 2016 Mar;21(3):283-91. doi: 10.1634/theoncologist.2015-0307. Epub 
      2016 Feb 10.