Loading
A pooled study of 1,966 women with early triple-negative breast cancer treated with surgery and radiotherapy but no chemotherapy, in which those whose tumours were half or more immune cells had 94 percent five-year freedom from distant relapse in stage I disease against 78 percent for immune-poor tumours.
Leon-Ferre, Jonas, Salgado, Loi and colleagues pooled individual patient data from 13 centres in North America, Europe and Asia for 1,966 patients diagnosed with triple-negative breast cancer between 1979 and 2017 who received surgery with or without radiotherapy but no adjuvant or neoadjuvant chemotherapy (median age 56; 55 percent stage I). Median tumour-infiltrating lymphocyte level was 15 percent; 417 (21 percent) had 50 percent or more (median age 41) and 1,300 (66 percent) less than 30 percent. In stage I disease five-year distant recurrence-free survival was 94 percent (95 percent confidence interval 91 to 96) with lymphocytes of 50 percent or more versus 78 percent (75 to 80) below 30 percent, and five-year overall survival 95 versus 82 percent. At a median follow-up of 18 years each 10 percent increment in lymphocytes was independently associated with better invasive disease-free survival (hazard ratio 0.92), recurrence-free survival (0.90), distant recurrence-free survival (0.87) and overall survival (0.88).
The evidence behind the stage I de-escalation statement on the triple-negative page: an ordinary haematoxylin and eosin slide identifies a fifth of patients whose outcome without chemotherapy matches treated cohorts. A prospective trial of chemotherapy omission is the missing step.
Shares Give exceptional responders less: pembrolizumab omission after complete response, anthracycline-free regimens and chemotherapy omission in lymphocyte-rich stage I disease, Hazard ratio (HR), Triple-negative breast cancer roadmap: from a remainder defined by three negative tests to immunotherapy, antibody-drug conjugates and the residual disease problem, Triple-negative breast cancer (TNBC) and the tag tnbc-evidence.
Shares Give exceptional responders less: pembrolizumab omission after complete response, anthracycline-free regimens and chemotherapy omission in lymphocyte-rich stage I disease, De-escalation, escalation and response-adapted therapy, Triple-negative breast cancer (TNBC) and the tag tnbc-evidence.
Shares Digital pathology & AI, Biomarkers are not validated or standardised, Triple-negative breast cancer roadmap: from a remainder defined by three negative tests to immunotherapy, antibody-drug conjugates and the residual disease problem, Triple-negative breast cancer (TNBC) and the tag tnbc-evidence.
Shares Hazard ratio (HR), Triple-negative breast cancer roadmap: from a remainder defined by three negative tests to immunotherapy, antibody-drug conjugates and the residual disease problem, Triple-negative breast cancer (TNBC) and the tag tnbc-evidence.
Shares Hazard ratio (HR), Biomarkers are not validated or standardised, Triple-negative breast cancer roadmap: from a remainder defined by three negative tests to immunotherapy, antibody-drug conjugates and the residual disease problem, Triple-negative breast cancer (TNBC) and the tag tnbc-evidence.
Shares Digital pathology & AI, Biomarkers are not validated or standardised, Triple-negative breast cancer roadmap: from a remainder defined by three negative tests to immunotherapy, antibody-drug conjugates and the residual disease problem, Triple-negative breast cancer (TNBC) and the tag tnbc-evidence.
Shares Tumour-infiltrating lymphocytes (TILs), Triple-negative breast cancer roadmap: from a remainder defined by three negative tests to immunotherapy, antibody-drug conjugates and the residual disease problem, Triple-negative breast cancer (TNBC) and the tag tnbc-evidence.
Shares Hazard ratio (HR), Triple-negative breast cancer roadmap: from a remainder defined by three negative tests to immunotherapy, antibody-drug conjugates and the residual disease problem, Triple-negative breast cancer (TNBC) and the tag tnbc-evidence.