Disparity in Tumor Immune Microenvironment of Breast Cancer and Prognostic Impact: Asian Versus Western Populations. (1st August 2019)

• Record Type: Journal Article
• Authors: Chen, Ching‐Hsuan; Lu, Yen‐Shen; Cheng, Ann‐Lii; Huang, Chiun‐Sheng; Kuo, Wen‐Hung; Wang, Ming‐Yang; Chao, Ming; Chen, I‐Chun; Kuo, Chun‐Wei; Lu, Tzu‐Pin; Lin, Ching‐Hung
• Is Part Of: Oncologist. Volume 25:Number 1(2020)
• Page Start: e16
• Page End: e23
• Publication Date: 2019-08-01
• Subjects: Immune cell -- Composition -- Breast cancer -- Asia -- Prognosis; Oncology -- Periodicals; Tumors -- Periodicals; Cancérologie -- Périodiques; Tumeurs -- Périodiques; Oncology; Tumors; Neoplasms; Electronic journals; Periodicals; Periodicals; 616.994
• DOI: 10.1634/theoncologist.2019-0123
• Languages: English
• ISSNs: 1083-7159

Abstract

Abstract: Background: The clinicopathological features and prognosis of breast cancer in Asia are different from those in the Western countries. Tumor‐infiltrating immune cells can influence the outcome of patients with breast cancer, but they have not been systemically evaluated in Asian patients with breast cancer. Methods: We compared the immune score, composition, and prognostic impact of infiltrating immune cells between Asian and Western patients with breast cancer by analyzing gene expression profiles from eight Gene Expression Omnibus data sets and The Cancer Genome Atlas data set. The Estimation of Stromal and Immune Cells in Malignant Tumours Using Expression Data (ESTIMATE) and Cell Type Identification by Estimating Relative Subsets of Known RNA Transcripts (CIBERSORT) algorithms were used to determine the immune score and composition of tumor‐infiltrating immune cells, respectively. Findings: This study included 462 Asian patients and 2, 186 Western patients. Tumors of Asian patients had significantly higher immune score, particularly in the luminal B and HER2‐enriched subtypes. High immune score was associated with favorable prognosis in both Asian and Western patients, and Asian race with a high ESTIMATE immune score provided additional power to predict longer disease‐free survival. Activated CD4 T cells and M2 macrophages were the most strongly associated with survival in both Asian and Western patients. Interpretation: Our study highlights the difference in tumor immune microenvironments between Asian and Western patients. The higher ESTIMATE immune score, which represents more abundant tumor‐infiltrating immune cells, in tumors of Asian patients partly explains their favorable prognosis. Abstract : Statistics indicate that the incidence of breast cancer in Asia has increased in the past three decades. This article evaluates tumor‐infiltrating immune cells of breast cancer, comparing a representative amount and the composition of infiltrating immune cells in breast cancer between Asian and Western patients.