Oops, you're using an old version of your browser so some of the features on this page may not be displaying properly.

MINIMAL Requirements: Google Chrome 24+Mozilla Firefox 20+Internet Explorer 11Opera 15–18Apple Safari 7SeaMonkey 2.15-2.23

Proffered Paper - Breast cancer, early stage

159O - 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

Date

20 Sep 2020

Session

Proffered Paper - Breast cancer, early stage

Presenters

Vincent De Jong

Citation

Annals of Oncology (2020) 31 (suppl_4): S303-S339. 10.1016/annonc/annonc267

Authors

V.M.T. De Jong1, Y. Wang1, M. Opdam1, N. ter Hoeve2, K. Jóźwiak3, M. Hauptmann3, N. Stathonikos2, H. Horlings4, A. Broeks5, S. Michiels6, E. van der Wall2, P. van Diest7, S. Siesling8, M.K. Schmidt1, S. Loi9, M. Kok10, S. Linn10, R.F. Salgado11, G. Dackus1

Author affiliations

  • 1 Molecular Pathology, Netherlands Cancer Institute/Antoni van Leeuwenhoek hospital (NKI-AVL), 1066 CX - Amsterdam/NL
  • 2 Cancer Center, UMC-University Medical Center Utrecht, 3584 CX - Utrecht/NL
  • 3 Institute Of Biostatistics And Registry Research, Brandenburg Medical School Theodor Fontane, Neuruppin/DE
  • 4 Pathology, Netherlands Cancer Institute/Antoni van Leeuwenhoek hospital (NKI-AVL), 1066 CX - Amsterdam/NL
  • 5 Core Facility Molecular Pathology &biobanking, Netherlands Cancer Institute/Antoni van Leeuwenhoek hospital (NKI-AVL), 1066 CX - Amsterdam/NL
  • 6 Team Oncostat, Cesp, Gustave Roussy, 94805 - Villejuif/FR
  • 7 Pathology, UMC-University Medical Center Utrecht, Utrecht/NL
  • 8 Research, Comprehensive Cancer Organization, Utrecht/NL
  • 9 Translational Breast Cancer Genomics Lab, Division Of Research, Peter MacCallum Cancer Center, 3002 - Melbourne/AU
  • 10 Medical Oncology, Netherlands Cancer Institute/Antoni van Leeuwenhoek hospital (NKI-AVL), 1066 CX - Amsterdam/NL
  • 11 Division Of Research, Peter Mac Callum Cancer Center, Melbourne/AU
More

Resources

Login to access the resources on OncologyPRO.

Abstract 159O

Background

Uncertainty exists whether all young (< 40 years) patients with triple negative breast cancer (TNBC) require (neo)adjuvant chemotherapy. Increasing stromal tumour infiltrating lymphocytes (TIL) have been associated with improved outcome. However, limited data are available for young patients. We investigated whether TIL could aid in identifying a subgroup of young TNBC patients for whom de-escalating (neo)adjuvant chemotherapy could be considered.

Methods

All women <40 years, diagnosed with TanyN0M0 breast cancer between 1989 and 2000 were selected from the Netherlands Cancer Registry. We excluded women who received adjuvant systemic treatment. ER, PgR, and HER2 status were reassessed and TIL were scored for the triple negative (ER/PgR < 10% and HER2 negative) subset according to an established standard. Multivariable Cox regression was performed for overall (OS) and distant recurrence-free survival (DRFS). We used continuous TIL score, T-stage, tumour grade, histological subtype, and local treatment as covariates. For DRFS we censored patients at the time of a second primary tumour.

Results

We identified 481 TNBC patients, with a median age of 35 years (range 22 – 39). Most tumours were grade 3 (86%), pT1C (49%), median TIL score was 25% (IQR 5 – 70). In total, 122 DRFS events (25%) (89 metastases, 33 deaths), and 170 deaths (35%) occurred during a median of 16.2 and 21.2 years follow-up, respectively. In total, 110 (23%) patients developed a second primary tumour. OS at 10 and 15 years for patients with TIL ≥ 30% and <75% (n=127) was 80% (95% CI 73 - 87) and 76% (95% CI 69 – 84), DRFS was 84% (95% CI 78 – 91) and 83% (95% CI 76 – 90), respectively. For patients with ≥ 75% TIL (n=107) OS and DRFS at 10 and 15 year were 95% (95% CI 91 – 99), 93% (95% CI 89 – 99), 98% (95% CI 95 – 100) and 98% (95% CI 95 – 100), respectively. Risk of death or DRFS event reduced significantly for each 10% TIL increment (aHRs 0.83; 95% CI 0.79-0.88 and 0.74; 95% CI 0.68-0.80, respectively).

Conclusions

In young (<40 year), systemically untreated, N0, TNBC patients TIL provide important prognostic information. Subsequent investigations to de-escalate systemic therapy in a subgroup of young TNBC patients may be warranted.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The PARADIGM study group.

Funding

ZonMw A Sister's Hope Vrienden UMC Utrecht.

Disclosure

S. Michiels: Advisory/Consultancy, Statistical advice: IDDI; Advisory/Consultancy, Statistical advice: Janssen; Advisory/Consultancy, Statistical advice: Cilag; Advisory/Consultancy, Independant Data Monitoring Committee: Hexal; Advisory/Consultancy, Independent Data Monitoring Committee: Steba; Advisory/Consultancy, Independent Data Monitoring Committee: IQVIA; Advisory/Consultancy, Independent Data Monitoring Committee: Roche; Advisory/Consultancy, Independent Data Monitoring Committee: Sensorion; Advisory/Consultancy, Independent Data Monitoring Committee: Biophytis; Advisory/Consultancy, Independent Data Monitoring Committee: Servier; Advisory/Consultancy, Independent Data Monitoring Committee: Yuhan. S. Loi: Advisory/Consultancy, Research grant/Funding (institution): Novartis; Advisory/Consultancy, Research grant/Funding (institution): Bristol-Meyers Squibb; Advisory/Consultancy, Research grant/Funding (institution): Merck; Advisory/Consultancy, Research grant/Funding (institution): Roche-Genentech; Research grant/Funding (institution): Puma Biotechnology; Advisory/Consultancy, Research grant/Funding (institution): Pfizer; Research grant/Funding (institution): Eli Lilly; Advisory/Consultancy, Research grant/Funding (institution): Seattle Genetics; Advisory/Consultancy: AstraZeneca; Advisory/Consultancy: Aduro Biotech; Advisory/Consultancy: GlaxoSmithKline; Advisory/Consultancy: G1 Therapeutics. M. Kok: Advisory/Consultancy, Research grant/Funding (institution): Bristol-Meyers Squibb; Research grant/Funding (institution): Roche-Genentech; Research grant/Funding (institution): AstraZeneca; Advisory/Consultancy: Daiichi Sankyo. S. Linn: Research grant/Funding (self): ZonMw; Research grant/Funding (self): A Sister's Hope ; Advisory/Consultancy, Research grant/Funding (institution), Non-remunerated activity/ies, institutional non-financial support: AstraZeneca; Advisory/Consultancy, Non-remunerated activity/ies, institutional non-financial support: Cergentis; Advisory/Consultancy, Non-remunerated activity/ies, institutional non-financial support: IBM; Advisory/Consultancy, Research grant/Funding (institution): Pfizer; Advisory/Consultancy, Research grant/Funding (institution), Non-remunerated activity/ies, institutional non-financial support: Roche-Genentech; Research grant/Funding (institution), Non-remunerated activity/ies, institutional non-financial support: Tesaro; Research grant/Funding (institution), Non-remunerated activity/ies, institutional non-financial support: immunomedics; Non-remunerated activity/ies: Bayer; Research grant/Funding (institution), institutional non-financial support: Agendia; Research grant/Funding (institution): Eurocept-pharmaceuticals; Research grant/Funding (institution): Novartis. R.F. Salgado: Advisory/Consultancy, Research grant/Funding (self), Travel/Accommodation/Expenses: Roche; Advisory/Consultancy: Bristol-Myers Squibb; Research grant/Funding (self), Travel/Accommodation/Expenses: Merck; Research grant/Funding (self): Puma Biotechnology; Travel/Accommodation/Expenses: AstraZeneca. All other authors have declared no conflicts of interest.

This site uses cookies. Some of these cookies are essential, while others help us improve your experience by providing insights into how the site is being used.

For more detailed information on the cookies we use, please check our Privacy Policy.

Customise settings