# Tumor-infiltrating lymphocytes and prognosis: a pooled individual patient analysis of early-stage triple-negative breast cancers

Source: https://onco.cc/key-papers/paper-loi-tils-pooled-early-tnbc-jco-2019/  
OnCo record `paper-loi-tils-pooled-early-tnbc-jco-2019` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Pooling 2,148 women from nine studies showed that every extra 10% of immune cells in the tumour stroma cut the risk of relapse by about 13%, and node-negative patients with 30% or more had a 97% chance of being free of distant relapse at three years.

## Summary

Individual data from 2,148 early TNBC patients in nine studies treated with anthracycline-based chemotherapy with or without taxanes were pooled; stromal TILs were scored the same way in each. Average sTILs were 23% (SD 20%) and 77% had 1% or more; sTILs were lower with older age, larger tumours, nodal involvement and lower grade. In multivariable models sTILs added independent prognostic information for invasive disease-free, distant disease-free and overall survival; each 10% increment gave hazard ratios of 0.87, 0.83 and 0.84. In node-negative patients with sTILs 30% or more, three-year iDFS was 92%, D-DFS 97% and OS 99%.

## Fields

- Kind: Key paper
- Last checked: 2026-09-24
- Journal: Journal of Clinical Oncology
- Year: 2019
- DOI: 10.1200/JCO.18.01010
- Authors: Loi S, Drubay D, Adams S, et al.
- Findings: Mean sTILs 23%; 77% of patients at 1% or more.; Each 10% sTIL increment: iDFS HR 0.87, D-DFS 0.83, OS 0.84.; Node-negative, sTILs 30% or more: three-year D-DFS 97%, OS 99%.
- What it means: TILs are the strongest cheap prognostic biomarker in early TNBC, scored on a standard slide, and the basis of the de-escalation trials that omit chemotherapy in small, lymphocyte-rich tumours.
- Caveats: Retrospective pooling of chemotherapy-treated trial patients.; Scoring reproducibility depends on the International TIL Working Group method.

## Sources

- Loi et al., J Clin Oncol 2019: pooled analysis of stromal TILs in 2,148 early TNBC patients: https://doi.org/10.1200/JCO.18.01010
- PubMed: https://pubmed.ncbi.nlm.nih.gov/30650045/
- TILs in breast cancer prognostic model: https://www.tilsinbreastcancer.org

## Connected records

- cancers: [Early triple-negative breast cancer](https://onco.cc/cancers/tnbc-early/), [Triple-negative breast cancer (TNBC)](https://onco.cc/cancers/tnbc/)
- terms: [Tumour-infiltrating lymphocytes (TILs)](https://onco.cc/terms/tils/)
- people: [Martine Piccart](https://onco.cc/people/martine-piccart/), [Sherene Loi](https://onco.cc/people/loi-sherene/)
- journals: [Journal of Clinical Oncology](https://onco.cc/journals/jco/)

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