ArticleJournal of the National Cancer Institute2021
Breast Tumor Microenvironment in Black Women: A Distinct Signature of CD8+ T-Cell Exhaustion.
Article in Journal of the National Cancer Institute, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 71 papers.
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Who cites it
71 citing papers in PubMed, 88 citations in OpenAlex.
- Racial disparities in outcomes of patients with stage I-III triple-negative breast cancer after adjuvant chemotherapy: a post-hoc analysis of the E5103 randomized trial.Breast cancer research and treatment · 2024Trial
- Association between cumulative lifetime exposure to reproductive hormones and tumor-infiltrating lymphocytes, CD4 +, and CD8 + T cells among women with breast cancer.Cancer immunology, immunotherapy : CII · 2026Article
- Association of tumor-infiltrating lymphocytes and proinflammatory biomarkers with breast cancer molecular subtypes: analysis of the MEND study.Breast cancer research and treatment · 2026Article
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- Racial Disparity in Ductal Carcinoma in Situ: Risk-Predictive and Actionable Biomarkers for Early Intervention.Cancers · 2026Review
- Topology-Based Biomarkers Accurately Predict Breast Cancer Outcome and Survival.Cancer research · 2026Article
- Immune gene diversity and STING1 variants in shaping cancer immunity across different genetic ancestry populations.Cell reports · 2026Article
- Comparative effectiveness of immunotherapy versus lenvatinib in advanced hepatocellular carcinoma: A real-world analysis using target trial emulation.Hepatology (Baltimore, Md.) · 2026Article
- Pan-immune-inflammation value: racial variations and differences in prognostic accuracy across breast cancer subtypes at a single institution.Frontiers in oncology · 2026Article
- Contrastive learning enhances fairness in pathology artificial intelligence systems.Cell reports. Medicine · 2025Article
- Breast Cancer Characteristics and Outcomes in Canadian Black Women by Ancestry.Current oncology (Toronto, Ont.) · 2025Article
- Multiomic Analysis Links Neighborhood Disadvantage to Inflammatory Proteins and Tumorigenic Markers in ER+ Breast Cancer Plasma and Tumor Samples.Journal of proteome research · 2025Article
- The African-Specific Variant in the Duffy Antigen Receptor for Chemokines Gene, CD8+ T-Cell Density, and Aggressive Breast Cancer Subtypes in Black Women.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2025Article
- Clinicopathological evaluation of triple-negative breast cancer treated with keynote-522 regimen.The oncologist · 2025Article
- Integrative spatial omics reveals distinct tumor-promoting multicellular niches and immunosuppressive mechanisms in Black American and White American patients with TNBC.Nature communications · 2025Article
- Quantitative analysis of T cell subsets in a population of Black women with invasive breast cancer.NPJ breast cancer · 2025Article
- Multiplex imaging reveals novel patterns of MRTFA/B activation in the breast cancer microenvironment.Journal of translational medicine · 2025Article
- Population-specific patterns in assessing molecular subtypes of young black females with triple-negative breast cancer.NPJ breast cancer · 2025Article
- Ancestral Differences in Anticancer Treatment Efficacy and Their Underlying Genomic and Molecular Alterations.Cancer discovery · 2025Article
11 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
16 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundBlacks tend to have a stronger inflammatory immune response than Whites. We hypothesized that racial differences in host immunity also manifest in the tumor microenvironment, constituting part of a distinct aggressive tumor biology underlying higher mortality in Black women.
methodsPathological and gene expression profiling approaches were used for characterizing infiltrating immune cells in breast tumor microenvironment from 1315 patients from the Women's Circle of Health Study. Racial differences in tumor immune phenotypes were compared, with results validated in a publicly accessible dataset. Prognostic associations of immune phenotypes were assessed in 3 independent cohorts.
resultsWe found marked and consistent differences in tumor immune responses between Black and White patients. Not only did tumors from Blacks display a stronger overall immune presence but also the composition and quality of immune infiltrates differed, regardless of tumor subtypes. Black patients had a stronger CD4+ and B-cell response, and further, a more exhausted CD8+ T-cell profile. A signature indicating a higher ratio of exhausted CD8+ T cells to total CD8+ T cells (ExCD8-r) was consistently associated with poorer survival, particularly among hormone receptor-positive patients. Among hormone receptor-negative patients, combinations of the absolute fraction of CD8+ T cells and ExCD8-r signature identified the CD8lowExCD8-rhigh subgroup, the most prevalent among Blacks, with the worst survival.
conclusionsOur findings of a distinct exhausted CD8+ T-cell signature in Black breast cancer patients indicate an immunobiological basis for their more aggressive disease and a rationale for the use of immune checkpoint inhibitors targeting the exhaustion phenotype.
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