Could patients with early form of breast cancer avoid chemotherapy?

Pharma News: Patients with early-stage triple-negative breast cancer (TNBC) and high levels of immune cells could be spared from intensive chemotherapy regimens.

TNBC, a particularly aggressive subtype of breast cancer, poses significant challenges due to its resistance to conventional hormone-targeting drugs. It tends to proliferate rapidly and metastasise beyond the breast, making it more likely to recur compared to other forms of breast cancer.

Peter MacCallum Cancer Centre researchers underscore the significance of immune cells, known as tumour-infiltrating lymphocytes (TILs), as a predictive biomarker for patients with early-stage TNBC, even in the absence of chemotherapy. TILs are natural immune system cells capable of infiltrating tumours and identifying cancer cells for destruction.

Dr Roberto Salgado, co-leader of the study and a member of the Loi Lab at Peter Mac, emphasised the implications of the findings, stating, “This meta-analysis confirms robustly the prognostic value of TILs that we have previously reported in TNBC patients treated with chemotherapy and expands it to patients treated without chemotherapy.”

He further explained, “Future studies may allow the use of this biomarker along with standard clinicopathological factors to inform treatment decisions in TNBC patients.”

In the meta-analysis, survival rates for early-stage TNBC treated with locoregional therapy but without adjuvant or neoadjuvant chemotherapy were 90% for patients with a TIL level of 50% or greater, compared with 72% for patients with a TIL level of less than 30% at 5-year follow-up.

Dr Salgado’s co-chair in the study, Professor Sherene Loi, a clinician and scientist at Peter Mac, expressed the significance of the research in reshaping treatment strategies for TNBC patients.

“While prior studies have focused on measuring TILs in people treated with chemotherapy, this is the largest study to comprehensively demonstrate that the presence of TILs influences the natural behaviour of breast cancer in people who have surgery and/or radiation with no additional medical treatment,” Professor Loi remarked.

The international collaboration, spearheaded by Dr Salgado and Professor Loi, involved 11 additional research groups, including partners from Mayo Clinic and Gustave Roussy.

The findings from this landmark research hold promise for personalised treatment approaches in TNBC, potentially sparing patients from the toxicities associated with intensive chemotherapy. Dr Salgado and Professor Loi’s pioneering work on the TIL biomarker has paved the way for future clinical trials aimed at optimising treatment strategies for TNBC patients.

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