Retrospective data of 481 systemically untreated, N0, young TNBC patients showed that increasing stromal tumour infiltrating lymphocytes (TIL) have a prognostic value for improved outcome .
The PARADIGM study group selected all women younger than 40 years, diagnosed with Tany/N0/M0 breast cancer between 1989 and 2000, from the Netherlands Cancer Registry, excluding women who received adjuvant systemic treatment.
A total of 481 TNBC patients (ER/PR <10% and HER2-negative) were identified (median age 35 years). Most tumours were grade 3 (86%), pT1C (49%). TIL were scored according to an established standard; median TIL score was 25% (IQR 5–70). In these patients, 122 distant recurrence-free survival events (25%; 89 metastases, 33 deaths) and 170 deaths (35%) occurred during a median of 16.2 and 21.2 years follow-up, respectively, and 110 (23%) patients developed a second primary tumour.
At 15 years, overall survival (OS) for patients with TIL <30% (n=247) was 59%, for patients with TIL between 30-75% (n=127) OS was 76%, and for patients with TIL ≥75% (n=107) OS was 93%. The incidence of death or distant metastases at 15 years was 39%, 16%, and 1.9% in the 3 respective TIL-groups. On the other hand, high stromal TIL was associated with a higher incidence of second primary tumours at 15 years (23%, 22%, and 14%, respectively).
In conclusion, this study shows a prognostic value for TIL in young TNBC patients. Young patients with high TIL have an excellent outcome without (neo)adjuvant chemotherapy.
- De Jong VMT, et al. Prognostic value of tumour infiltrating lymphocytes in young triple negative breast cancer patients who did not receive adjuvant systemic treatment; by the PARADIGM study group. ESMO 2020 Virtual Meeting, abstract 159O.
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