ArticleBreast (Edinburgh, Scotland)2025
Prognostic value of tumor-infiltrating lymphocytes in irradiated node-positive breast cancer patients.
Article in Breast (Edinburgh, Scotland), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Associations between tumor immune response and prognosis in node-negative breast cancer patients in the randomized DBCG HYPO trial.BMC cancer · 2026Trial
- Immune Cell Composition and Prognosis in Node-Positive, Irradiated Breast Cancer Patients in the DBCG-IMN2 Study.APMIS : acta pathologica, microbiologica, et immunologica Scandinavica · 2026Article
- Engineering macrophages for cancer immunotherapy: emerging insights and therapeutic potential.npj biomedical innovations · 2026Review
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7 authors.
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Abstract
introductionRadiotherapy significantly reduces locoregional recurrence (LRR) and improves survival. Yet, reliable biomarkers predicting radiotherapy response are not well-defined. Tumor-infiltrating lymphocytes (TILs) have emerged as a promising prognostic and predictive marker, but their role in irradiated patients remains underexplored.
methodsThis case-cohort study included 1461 node-positive, irradiated breast cancer patients from the Danish Breast Cancer Group (DBCG) internal mammary node (IMN)2 study. IMN irradiation (IMNI) was allocated by tumor laterality. TILs were assessed in treatment-naïve primary tumors and dichotomized using a 30 % cut-off. Endpoints included overall mortality (OM), breast cancer-specific mortality (BCM), distant recurrence (DR), and LRR. Flexible parametric survival models estimated adjusted hazard ratios (HRs).
resultsTILs were evaluated in 1353 patients; 20 % had high TILs. Low TILs were associated with higher OM (HR 0.53, 95 % CI: 0.36-0.77), BCM (HR 0.45, CI: 0.29-0.71) and DR (HR 0.40, CI: 0.26-0.62), but not LRR (HR 0.82, CI: 0.31-2.17). These associations were strongest in estrogen receptor-negative (ER-) tumors. ER-/low TILs were associated with increased OM (HR 0.31, CI: 0.18-0.56) compared to ER-/high TILs, whereas TILs were not prognostic in ER+ tumors (HR 0.86, CI: 0.56-1.32). A significant survival benefit after IMNI was observed in patients with low TILs tumors (HR 0.64, CI: 0.48-0.85), but TILs did not predict IMNI-benefit.
conclusionTILs in the pre-immunotherapy setting were not predictive of IMNI-benefit but prognostic for post-radiotherapy outcomes in node-positive patients. The effect was dependent on ER status, as patients with ER-/low TILs tumors had poorer survival with a trend toward increased DR-risk.
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