Experts Find New Ways to Predict Response to Chemo in Triple-negative Breast Cancer

Researchers from University Hospitals (UH) Case Medical Center's Seidman Cancer Center found that the presence of tumor-infiltrating lymphocytes, a type of white blood cell, ahead of treatment, may help predict response to platinum-based chemotherapy in women with triple-negative breast cancer. The data, which comes from the PrECOG 0105 trial, will be presented at the 50th annual meeting of the American Society for Clinical Oncology (ASCO) being held in Chicago, Il, May 30 - June 3, 2014.

"Triple-negative breast cancers or TNBC tends to be more aggressive compared to other types of breast cancers, and being able to predict response to therapy could greatly impact treatment decisions and patient outcomes," says study author Shaveta Vinayak, MD, oncologist at UH Case Medical Center and Assistant Professor at Case Western Reserve University School of Medicine. "Our research shows that the presence of lymphocytes before administering chemotherapy could predict a positive response to platinum-based therapy."

Difficult to treat
Triple negative breast cancers or TNBCs are a form of breast cancer that does not have estrogen or progesterone receptors, and do not have an excess of the HER2 protein on the cancer cell surfaces. This makes it more difficult to treat because the hormone-blocking or the HER2-targeting treatments do not work. Triple negative breast cancers tend to occur more often in younger women and in African-American women.


...PrECOG 0105 trial evaluated neoadjuvant platinum-based chemotherapies in women with triple-negative breast cancer or TNBC...


Treatment options
Platinum-based therapies are being tested in clinical trials for triple-negative breast cancer, and evaluation of tumor-infiltrating lymphocytes is an important factor in determining response to this treatment. For oncologists, this could provide a new tool to individualize treatment for these women.

In the PrECOG 0105 trial researchers evaluated neoadjuvant platinum-based chemotherapies – carboplatin, gemcitabine and iniparib – in women with triple-negative breast cancer. In this correlative study they assessed the association of tumor-infiltrating lymphocytes in pre-treatment breast cancer tissue with pathologic response to treatment.

In the trial the researchers evaluated 70 patients with triple-negative breast cancer who had completed at least 4 of 6 planned cycles of therapy. Tissue and tumor sections from pre-chemotherapy biopsies were evaluated by a central pathologist for density of lymphocytes. Pathologic response was assessed by the residual cancer burden index.

Trial results
Results showed that tumor-infiltrating lymphocytes found in the connective tissue and the tumor itself are predictive of response to platinum-based neoadjuvant chemotherapy and are significantly associated with triple-negative breast cancer subtypes, with the highest frequency in the immunomodulatory subtype.

Researchers from various institutions in the Eastern Cooperative Oncology Group (ECOG), one of the largest clinical cancer research organizations in the United States that conducts clinical trials in all types of adult cancers, contributed to this analysis.

For more information:
Oral Abstract Session Breast Cancer - Triple-Negative/Cytotoxics/Local Therapy
ASCO 2014 Abstract #1024: June 3, 2014 9:45 AM - 12:45 PM

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