Journal
CANCER TREATMENT REVIEWS
Volume 57, Issue -, Pages 8-15Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.ctrv.2017.04.005
Keywords
Tumor-infiltrating lymphocytes; Neoadjuvant treatment; HER2-postive breast cancer; Pathologic complete response; Trastuzumab; Lapatinib
Categories
Funding
- Belgian Fund for Scientific Research (FNRS)
- Les Amis de l'Institut Bordet
- FNRS-Operation Televie and Plan Cancer of Belgium
Ask authors/readers for more resources
Background: A relationship between baseline tumor-infiltrating lymphocytes (TIL) and outcomes has been described in HER2-positive breast cancer. Nevertheless, the magnitude of this association and whether this effect differs based on the type of anti-HER2 agent remain controversial. This meta-analysis investigated the association between baseline TIL and pathologic complete response (pCR) rates in HER2-positive breast cancer patients treated with neoadjuvant chemotherapy plus trastuzumab and lapatinib either alone or in combination. Methods: A literature search covering PubMed, Embase and the Cochrane library up to October 31, 2016 identified randomized, controlled trials investigating neoadjuvant chemotherapy plus trastuzumab and lapatinib either alone or in combination where published data for pCR based on pre-treatment TIL scores were available. Two subgroups were considered: high baseline TIL vs. non-high TIL, according to each study definition. Summary risk estimates (odds ratio) and 95% confidence intervals (CI) were calculated for pCR using pre-treatment TIL levels for each trial. Pooled analyses were conducted using random and fixed effects models. Interaction P-values were computed using a Monte Carlo permutation test. Results: A total of 5 studies (N = 1256 patients) were included. Overall, high TIL subgroup was associated with a significantly increased pCR rate (OR 2.46; 95% CI 1.36-4.43; P = 0.003). No interaction was observed between TIL subgroup (high vs. non-high TIL) and response to anti-HER2 agent(s) (trastuzumab vs. lapatinib vs. their combination; P = 0.747) and chemotherapy (anthracycline and taxanes vs. taxanes only; P = 0.201). A stronger association between high TIL subgroup and pCR rates was observed when examining only the 4 studies using anthracycline- and taxane- based neoadjuvant chemotherapy and the 60% cut-off for high TIL (N = 869, NeoALTTO excluded) with an OR of 2.88 (95% CI 2.03-4.08; P < 0.001). Conclusions: In HER2-positive breast cancer, high baseline TIL are associated with increased pCR probability irrespective of neoadjuvant anti-HER2 agent(s) and chemotherapy regimens used. (C) 2017 Elsevier Ltd. All rights reserved.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available