Prognostic role of immune environment in luminal B early breast cancer. (7th February 2023)

• Record Type: Journal Article
• Authors: Chan, Arlene; Gill, Jespal; Chih, HuiJun; Nelson, Delia J.
• Is Part Of: Cancer medicine. Volume 12:Number 7(2023)
• Page Start: 8278
• Page End: 8288
• Publication Date: 2023-02-07
• Subjects: anti‐cancer immunity -- checkpoint molecules -- luminal B breast cancer -- predictive -- prognostic; 616.994005
• DOI: 10.1002/cam4.5642
• Languages: English
• ISSNs: 2045-7634

Abstract

Abstract: The importance of the immune microenvironment in triple negative and HER2‐amplified breast cancer (BC) is well‐established; less is known about the immune environment in luminal breast cancers. We aimed to assess for the impact of immune biomarkers on BC outcome in a group of luminal B patients with archived tissue and annotated clinical information. Patients with early breast cancer (EBC) treated in a single institution over a 14‐year period, with prospectively collected data were included. Luminal B EBC patients were identified and defined into three cohorts: A: grade 2 or 3, ER & PR positive, HER2‐negative; B: Any grade, ER positive, PR and HER2‐negative (Ki67 ≥ 14% in cohorts A & B); and C: Any grade, ER or PR positive, HER2‐positive. Within each cohort, patients with a relapsed BC event (R) were compared on a 1:1 basis with a control patient (C) who remained disease‐free, balanced for key characteristics in an effort to balance the contribution of each clinical group to outcome. Archival breast, involved and uninvolved axillary nodes were assessed by immunohistochemistry for biomarkers identifying effector and suppressor immune cells, and compared between R and C. In total, 120 patients were included (80, 22, and 18 patients in cohorts A, B, and C, respectively). R were 1.5 years older ( p = 0.016), with all other characteristics being balanced. Overall, there were no statistically significant differences in immune biomarkers in breast or nodal tissue of R and C. However, there was a trend toward higher levels of TILs in breast tumors of C, while GAL‐9 was consistently expressed on lymphocytes and tumor cells in all breast and nodes of C and was absent from all tissues of R. These trends in checkpoint molecule expression deserve further research. Abstract : Our study assessed a number of immune cells and molecules beyond TILs, simultaneously in the primary breast tumor and involved and uninvolved axillary nodes and assessed the impact of these findings on patient clinical outcomes. It was of interest that we found consistent absence of GAL‐9+ tumor cells in the breast or involved nodes of relapsed patients, while GAL‐9+ tumor cells were seen in the controls. Collectively, published data suggest GAL‐9 to be an important molecule that should be further evaluated, taking into account the presence or absence of other checkpoint proteins in the tumor microenvironment.