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HER2 阳性乳腺癌中的 TIL(肿瘤浸润淋巴细胞):潜在影响与挑战

英文原题:Tumor-infiltrating lymphocytes in HER2-positive breast cancer: potential impact and challenges.

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Tumor-infiltrating lymphocytes in HER2-positive breast cancer: potential impact and challenges.

PubMed 2025/01/17(内容时间) ESMO Open Q1 · IF 10.6(JCR 2025)

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研究概要

TILs 是 HER2 阳性乳腺癌中一个有前景的生物标志物,尤其是在早期疾病阶段。这种评估可以指导治疗降阶梯或升阶梯,使治疗根据患者个体特征进行调整。由于其预后重要性,TILs 可以添加到病理报告中。然而,要在临床实践中广泛采用 TILs,仍必须在临床试验中进一步验证。

研究思路结论见上方概要

在这篇综述中,我们评估了基质TIL(肿瘤浸润淋巴细胞)(sTILs)作为人表皮生长因子受体2(HER2)阳性乳腺癌生物标志物的作用,探讨了其在不同治疗背景下的预后和预测潜力。

总结了早期和转移性设置下多项临床试验的数据,重点关注TILs与病理完全缓解(pCR)、无进展生存期(PFS)以及早期和转移性HER2阳性乳腺癌总生存期的相关性。本综述还讨论了TILs的评估方法、观察者间变异性和评估TILs的新兴技术。

TILs 已被确定为一种高度可重复的生物标志物,可预测接受新辅助治疗患者的 pCR,并在包括 HER2 阳性在内的多种乳腺癌亚型中作为长期结局的预后指标。研究表明,较高的 TIL 水平与更好的无复发生存率相关。尽管有这些发现,对于用于临床决策的最佳 TIL 阈值尚未达成共识,并且需要进一步研究如何将 TILs 纳入常规临床实践。

展开英文摘要原文

Data from multiple clinical trials in the early and metastatic settings, focusing on TILs' correlation with pathologic complete response (pCR), progression-free survival (PFS), and overall survival across early and metastatic HER2-positive breast cancer were summarized. This review also discusses TILs' assessment methods, interobserver variability, and emerging technologies to assess TILs.

TILs have been identified as a highly reproducible biomarker that predicts pCR in patients receiving neoadjuvant therapy and serves as a prognostic indicator for long-term outcomes in several breast cancer subtypes, including HER2-positive. Studies indicate that higher TIL levels correlate with better recurrence-free survival rates. Despite these findings, there is no consensus on the optimal TIL threshold for clinical decision making, and further research is required on how to incorporate TILs into routine clinical practice.

TILs represent a promising biomarker in HER2-positive breast cancer, particularly in early disease settings. This assessment could guide treatment de-escalation or intensification, tailoring therapies to individual patient profiles. Due to their prognostic importance, TILs can be added to pathology reports. However, further validation in clinical trials is essential for the widespread adoption of TILs in clinical practice.

论文信息

作者
Schlam I、Loi S、Salgado R、Swain SM
第一作者单位
Department of Medical Oncology, Dana Farber Cancer Institute, Boston, USA; Harvard Medical School, Boston, USA. Electronic address: https://twitter.com/ilanaschlam.United States
通讯作者单位
Georgetown Lombardi Comprehensive Cancer Center, Washington, USA; MedStar Health, Columbia, Maryland, USA. Electronic address: sms248@georgetown.edu.United States
文献类型
综述
期刊
ESMO open2025 Feb
原文标识
PubMed 39826475 · DOI 10.1016/j.esmoop.2024.104120