194P - Comparisons of tumor-infiltrating lymphocytes and 21-gene recurrence score in ER-positive/HER2-negative breast cancer

Date 11 September 2017
Event ESMO 2017 Congress
Session Poster display session
Topics Breast Cancer
Pathology/Molecular Biology
Basic Scientific Principles
Presenter Sung Gwe Ahn
Citation Annals of Oncology (2017) 28 (suppl_5): v43-v67. 10.1093/annonc/mdx362
Authors S.G. Ahn1, Y.J. Cha2, C. Yoon1, S.J. Bae1, J. Kim3, J. Jeong1
  • 1Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, 135-720 - Seoul/KR
  • 2Pathology, Gangnam Severance Hospital, 06229 - Seoul/KR
  • 3Surgery, Kangnam Mizmedi Hospital, 06229 - Seoul/KR



Recent meta-analysis showed that tumors with high tumor-infiltrating lymphocyte (TIL) have a higher probability of pathologic complete response even in Luminal/HER2-negative breast cancer. Also, the 21-gene recurrence score (RS) predicts the clinical benefit of chemotherapy for ER-positive/HER2-negative women. We compared two markers in those cancer.


In ER-positive/HER2-negative patients treated with primary surgery, the RS (Oncotype DX® Breast Cancer Assay; Genomic Health, Inc., USA) was obtained. We evaluated TIL in H&E slides of surgical specimens by standardized methodology proposed by the international TIL-working group. In 198 women, the percentage of stromal TIL was successfully assessed. In accordance with the recent meta-analysis, the degree of TILs were categorized as high ( > =60%), intermediate (11-59%), and low ( 


Ninety-seven (49.0%), 88 (44.4%), and 13 patients (6.6%) had low, intermediate, and high TILs, respectively. There is a significant but weak correlation between continuous RS and continuous TIL (Pearson’s R = 0.201, P = 0.004). The average of continuous RS was significantly highest in the high TIL tumors (17.8±10.7 in low TIL, 19.4±8.7 in intermediate TIL, and 26.2±8.2 in high TIL; P = 0.014). Whereas the average of continuous TILs was compared according to categorized RS, it was significantly higher in the intermediate RS or the high RS tumors (15.4±13.2 in low RS, 26.6±13.6 in intermediate RS, and 19.8±19.2 in high RS; P 


We found that tumors with high TIL tend to have a higher RS in ER-positive/HER2-negative breast cancer. We also noted that the rate of high-TIL tumors was significantly higher in the intermediate-RS tumors as well as in the high-RS tumors. Clinically, our findings suggest that TIL count might be referred in decision-making of chemotherapy in the intermediate RS-patients.Table:


Low or Intermediate TILHigh TILP-vlaue
Low RS (N = 98)97 (99%)1 (1%)0.007
Intermediate RS (N = 80)70 (88%)10 (12%)
High RS (N = 20)18 (90%)2 (10%)

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This research was supported by the Basic Science Research Program through the NRF, funded by the Ministry of Science, ICT, & Future Planning (NRF-2015R1C1A1A02037104), and grant from the National R&D Program for Cancer Control, Ministry of Health & Welfare, Republic of Korea (1520120).


All authors have declared no conflicts of interest.