Triple-negative breast cancer patients could avoid chemotherapy

Publicly released:
Australia; International; VIC

Peter Mac researchers are part of a major international study that has found patients with early-stage triple-negative breast cancer (TNBC) and high levels of immune cells could be spared from intensive chemotherapy regimens.

Media release

From: Peter MacCallum Cancer Centre

Peter Mac researchers are part of a major international study that has found patients with early-stage triple-negative breast cancer (TNBC) and high levels of immune cells could be spared from intensive chemotherapy regimens.

TNBC is a breast cancer subtype that does not respond to drugs that target the estrogen receptor or the HER2 protein. It grows rapidly, is more likely to spread beyond the breast before diagnosis and is more likely to recur than other breast cancers.

The study, published recently in the Journal of American Medical Association (JAMA), highlights the abundance of immune cells, also known as tumour-infiltrating lymphocytes (TILs) in breast tissue is a prognostic biomarker in people with early-stage TNBC, even when chemotherapy is not administered.

TILs are naturally existing immune system cells that can move from the bloodstream into a tumour and can recognise and destroy cancer cells.

Peter Mac’s Dr Roberto Salgado, co-leader of the study and a member of the Loi Lab, said the findings will hopefully pave the way for future clinical trials to explore whether patients with a favourable prognosis (high TILs) can avoid chemotherapy.

"This meta-analysis confirms robustly the prognostic value of TILs that we have previously reported in TNBC patients treated with chemotherapy and expands it to patients treated without chemotherapy," he said.

“Future studies may allow the use of this biomarker along with standard clinicopathological factors to inform treatment decisions in TNBC patients. The results of this study could lead to a recommendation to include TILs in the pathology reports of early-stage TNBC worldwide, as it has the potential to inform clinicians and patients when they discuss treatment options.”

Dr Salgado and Professor Sherene Loi, clinician and scientist at Peter Mac, are the founders and co-chairs of the International Immuno-Oncology Biomarker Working Group.

The Group, in collaboration with Mayo Clinic and Gustave Roussy researchers, led 11 additional groups to collect data on 1,966 participants with early-stage TNBC who only underwent surgery with or without radiation therapy but did not receive chemotherapy and follow participants followed for a median of 18 years.

Dr Salgado and Professor Loi have pioneered the development of the TIL biomarker in breast cancer and have led a large body of evidence with regards to their clinical relevance and utility in the prognosis and treatment of early and late-stage breast cancer patients.

“While prior studies have focused on measuring TILs in people treated with chemotherapy, this is the largest study to comprehensively demonstrate that the presence of TILs influences the natural behavior of breast cancer in people who have surgery and/or radiation with no additional medical treatment," Professor Loi said.

Journal/
conference:
JAMA
Research:Paper
Organisation/s: Peter MacCallum Cancer Centre
Funder: This research was supported in part by the following grants: National Research Agency and General Secretariat for Investment (RHU MyPROBE and ANR-17-RHUS-0008; Jonas, André, and Michiels); Clinical and Translational Science Awards (KL2 TR002379) from the National Center for Advancing Translational Science and the Mayo Clinic K2R Research Pipeline Award Tumor-Infiltrating Lymphocytes in Triple-Negative Breast Cancer Original Investigation Research jama.com (Reprinted) JAMA April 2, 2024 Volume 331, Number 13 1143 Confidential: Embargoed Until 11:00 am ET, April 02, 2024. Do Not Distribute © 2024 American Medical Association. All rights reserved. (Leon-Ferre); the Mayo Clinic Breast Cancer SPORE grant (P50 CA116201) from NCI (Leon-Ferre, Suman, and Goetz); the Breast Cancer Research Foundation (17-194; Salgado); the Cancer Research Society of Canada (944513; Nielsen, Leung, and Riaz); institutional grants from the Dutch Cancer Society (NKI 2018-11655), The Netherlands Organization for Health Research and Development (project number 836021019), A Sister’s Hope Foundation, De Vrienden van UMC Utrecht Foundation, and the [Z]aan deWandel Foundation to the Netherlands Cancer Institute (Kok and Linn); and the National Breast Cancer Foundation of Australia Endowed Chair and the Breast Cancer Research Foundation, New York (Loi).
Media Contact/s
Contact details are only visible to registered journalists.