CELL INTELLIGENCE · 肿瘤细胞治疗研究

This study evaluated epidemiologic and immune factors associated with pathologic complete response (pCR), breast cancer-specific survival (BCSS) and disease-free survival (DFS) outcomes in inflammatory (IBC) and locally advanced breast cancer (LABC) patients.

Tumor-infiltrating lymphocytes (TILs) and CD20 + B-cell frequencies (CD20 + ), and PD-L1 expression on tumor (PD-L1 + carcinoma cells) and immune (PD-L1 + TILs) cells were analyzed by immunohistochemistry along with clinicopathologic factors as modifiers of pCR and outcomes in 221 IBC and 162 LABC patients. Analysis included Kaplan-Meier curves and Cox proportional hazard models.

IBC and LABC display similar levels of TILs, CD20 + , and combined CD20 + and PD-L1 + TILs (CD20 + PD-L1 + TILs), while LABC contained more PD-L1 + TILs and PD-L1 + carcinoma cells. Absence of lymphovascular involvement, high TILs, PD-L1 + carcinoma cells, and combined CD20 + and PD-L1 + carcinoma cells correlated with pCR in IBC and LABC patients. High PD-L1 + TILs correlated with pCR only in LABC; less lymph node involvement at diagnosis, CD20 + and CD20 + PD-L1 + TILs correlated with pCR only in IBC (P < 0.04, all comparisons). Achievement of pCR in IBC and LABC patients correlated with BCSS and DFS (P < 0.02). In multivariate analyses, pCR remained an independent prognostic factor of improved DFS in IBC and LABC patients, but of BCSS in only LABC. CD20 + PD-L1 + TILs remained an independent prognostic factor of improved DFS and BCSS only in IBC.

CD20 + PD-L1 + TILs are an independent prognostic biomarker of improved outcomes in IBC, but not LABC. Selecting IBC patients by CD20 and PD-L1 status could stratify patients and potentially identify those in whom activating CD20 agents and anti-PD-1/PD-L1 therapy could be explored.