# Tumour-infiltrating lymphocytes and prognosis in different subtypes of breast cancer: a pooled analysis of 3771 patients treated with neoadjuvant therapy

Source: https://onco.cc/key-papers/paper-denkert-tils-neoadjuvant-pooled-lancet-oncol-2018/  
OnCo record `paper-denkert-tils-neoadjuvant-pooled-lancet-oncol-2018` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

In 906 triple-negative patients from six German trials, half of the tumours with dense lymphocytes disappeared completely on chemotherapy before surgery against under a third of those with few, and more lymphocytes meant longer survival.

## Summary

Pre-treatment core biopsies from 3,771 patients in six German Breast Group neoadjuvant trials were scored for stromal TILs by International TIL Working Group methods in three groups: low (0 to 10%), intermediate (11 to 59%) and high (60% or more). In TNBC, pCR was 31% (80 of 260) with low, 31% (117 of 373) with intermediate and 50% (136 of 273) with high TILs (P less than 0.0001); a 10% TIL increase was associated with longer disease-free survival (HR 0.93) and overall survival (HR 0.92). TILs predicted response in all subtypes but were an adverse survival factor in luminal-HER2-negative disease.

## Fields

- Kind: Key paper
- Last checked: 2026-09-24
- Journal: The Lancet Oncology
- Year: 2018
- DOI: 10.1016/S1470-2045(17)30904-X
- Authors: Denkert C, von Minckwitz G, Darb-Esfahani S, et al.
- Findings: TNBC (906 patients): high TILs (60% or more) in 273, 30%; pCR 50% with high versus 31% with low TILs.; 10% TIL increase: TNBC disease-free survival HR 0.93, overall survival HR 0.92.; TILs were adverse for survival in luminal-HER2-negative disease.
- What it means: It fixes the lymphocyte-predominant share of TNBC at about 30% and shows TILs predict chemotherapy response before immunotherapy enters the picture.
- Caveats: Trial populations; non-standard regimens in some trials.; Three-band grouping; continuous scoring is now preferred.

## Sources

- Denkert et al., Lancet Oncol 2018: TILs in 3,771 neoadjuvant patients from six German Breast Group trials: https://doi.org/10.1016/S1470-2045(17)30904-X
- PubMed: https://pubmed.ncbi.nlm.nih.gov/29233559/

## Connected records

- cancers: [Breast cancer (all types)](https://onco.cc/cancers/breast-cancer/), [Early triple-negative breast cancer](https://onco.cc/cancers/tnbc-early/), [Triple-negative breast cancer (TNBC)](https://onco.cc/cancers/tnbc/)
- companies: [German Breast Group (GBG)](https://onco.cc/companies/gbg/)
- terms: [Pathologic complete response (pCR)](https://onco.cc/terms/pcr/), [Tumour-infiltrating lymphocytes (TILs)](https://onco.cc/terms/tils/)
- people: [Carsten Denkert](https://onco.cc/people/carsten-denkert/), [Sibylle Loibl](https://onco.cc/people/sibylle-loibl/)
- journals: [The Lancet Oncology](https://onco.cc/journals/lancet-oncology/)

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