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Prognostic value of tumour infiltrating lymphocytes in young TNBC patients

ESMO 2020
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 [1].

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.

  1. 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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