A model combining pretreatment MRI radiomic features and tumor-infiltrating lymphocytes to predict response to neoadjuvant systemic therapy in triple-negative breast cancer

Jimenez, Jorge E.; Abdelhafez, Abeer H; Mittendorf, Elizabeth A.; Elshafeey, Nabil; Yung, Joshua P.; Litton, Jennifer K.; Adrada, Beatriz E.; Candelaria, Rosalind P.; White, Jason B.; Thompson, Alastair; Huo, Lei; Wei, Peng; Tripathy, Debu; Valero, Vicente; Yam, Clinton; Hazle, John D.; Moulder, Stacy L.; Yang, Wei Tse; Rauch, Gaiane M.

doi:10.1016/j.ejrad.2022.110220

Cited by 22 publications

(12 citation statements)

References 39 publications

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“…The systematic literature search returned 2366 records. After all exclusions, 12 eligible RCTs [ [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] ] and 17 case-control studies [ [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] ] were included, consisting of approximately 9145 participants ( Fig. 1 ).…”

Section: Resultsmentioning

confidence: 99%

Predictive and prognostic values of tumor infiltrating lymphocytes in breast cancers treated with neoadjuvant chemotherapy: A meta-analysis

Zhang

et al. 2022

The Breast

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Section: Resultsmentioning

confidence: 99%

Predictive and prognostic values of tumor infiltrating lymphocytes in breast cancers treated with neoadjuvant chemotherapy: A meta-analysis

Zhang

et al. 2022

The Breast

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“…A high expression of stromal TILs was detected in 14.83%, 24.20%, and 33.44% of HR-positive BC cases, HER-2-positive BC cases, and TNBC cases, respectively. Compared to HR-positive BC, TNBC and HER-2positive BC have stronger immunogenicity and can induce an antitumor immune response in the body to a greater extent; Asano [18] 2018 Japan 177 tBC (HR positive, HER-2 positive, TNBC) 10% FEC-P/PH Denkert [10] 2018 Germany 3651 tBC 60% NR Dong [19] 2020 China 170 TNBC 20% TEC Floris [20] 2021 Belgium 445 TNBC 30% NR Hwang [21] 2018 Korea 248 tBC 50% NR Hong [22] 2021 China 461 tBC 10% NR Ha [23] 2021 Korea 173 HER-2 positive 20% TCHP Jimenez [24] 2022 USA 80 TNBC 20% NR Kashiwagi [25] 2022 Japan 239 tBC (HR positive, HER-2 positive, TNBC) 10% FEC-P/PH Li [26] 2020 China 282 tBC 60% TAC/EC-P/T/TH Ochi [27] 2019 Japan 209 HER-2 positive, TNBC 10% NR Pang [28] 2021 China 310 TNBC 20% NR Wang [29] 2022 China 303 TNBC 50% PC FEC-P/PH = fluorouracil epirubicin cyclophosphamide-paclitaxel/paclitaxel trastuzumab, HER-2 = human epidermal growth factor receptor 2, HR = hormone receptor, NR = not reported, TAC/EC-P/T/TH = docetaxel epirubicin cyclophosphamide/epirubicin cyclophosphamide-paclitaxel/docetaxel/docetaxel trastuzumab, tBC = total breast cancer, TCHP = docetaxel carboplatin trastuzumab pertuzumab, TEC = docetaxel epirubicin cyclophosphamide, TNBC = triple-negative breast cancer, PC = paclitaxel carboplatin. www.md-journal.com consequently, stromal TILs are highly expressed in these 2 subtypes of BC.…”

Section: Discussionmentioning

confidence: 99%

Predictive value of stromal tumor-infiltrating lymphocytes in patients with breast cancer treated with neoadjuvant chemotherapy: A meta-analysis

Xia,

Zhang,

Jiang

et al. 2024

Medicine

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Background: The predictive value of tumor-infiltrating lymphocytes (TILs) in response to neoadjuvant chemotherapy (NAC) for breast cancer (BC) has received increasing attention. Here, a meta-analysis was conducted to evaluate the correlation between the expression of stromal TILs and pathological complete response (pCR) after NAC in BC patients. Methods: The PubMed, Embase, Cochrane Library, and Web of Science databases were searched online by using a combination of keywords and free words to screen literature on the expression of stromal TILs and pCR after NAC in patients with BC. The data were extracted and evaluated for quality. Relative risk (RR) was used to evaluate the relationship between the expression of stromal TILs before NAC and pCR in BC patients. Meta-analysis was performed with Review Manager 5.3 and STATA 14.0 software. Results: Eleven studies involving 6039 BC patients were included in the meta-analysis. The results showed a generally high expression of stromal TILs in BC patients, and the pCR rate after NAC in BC patients with a high expression of stromal TILs was significantly higher than that in BC patients with a low expression of stromal TILs [RR = 1.83, 95% confidence interval (CI): 1.69–1.97]. Subgroup analysis based on the molecular subtypes of BC showed that the pCR rate was significantly higher in patients with a high expression of stromal TILs in hormone receptor (HR)-positive BC [RR = 3.23, 95% CI: 2.43–4.30], human epidermal growth factor receptor 2 (HER-2)-positive BC [RR = 1.41, 95% CI: 1.25–1.60], and triple-negative BC [RR = 1.70, 95% CI: 1.53–1.90] than in those with a low expression of stromal TILs. Subgroup analysis based on expression threshold showed that the pCR rate was higher in patients with a high expression of stromal TILs than in patients with a low expression of stromal TILs at different expression thresholds (10% [RR = 1.99, 95% CI: 1.55–2.55], 20%/30% [RR = 1.57, 95% CI: 1.37–1.81], 50%/60% [RR = 1.91, 95% CI: 1.73–2.11]. Conclusion: TILs can be used as a predictor of pCR after NAC in patients with BC, and the appropriate high expression threshold of stromal TILs should be selected as the predictive value according to the molecular subtype of BC.

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“…When we applied the RMs in a discrete NACT cohort, the scores remarkably differed according to treatment responses. Several RMs have been developed to predict response to NACT in breast cancer ( 30 , 39 – 43 ); however, the biological backgrounds of the models have not been studied well. In line with the reported positive correlation between CD8 + T cell infiltration and response to NACT ( 23 , 24 ), this study demonstrated the link between RMs and differential response to NACT, mediated by the infiltration of CD8 + T cells.…”

Section: Discussionmentioning

confidence: 99%

Radiomic models based on magnetic resonance imaging predict the spatial distribution of CD8+ tumor-infiltrating lymphocytes in breast cancer

Jeon

Kim

et al. 2022

Front. Immunol.

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Infiltration of CD8+ T cells and their spatial contexture, represented by immunophenotype, predict the prognosis and therapeutic response in breast cancer. However, a non-surgical method using radiomics to evaluate breast cancer immunophenotype has not been explored. Here, we assessed the CD8+ T cell-based immunophenotype in patients with breast cancer undergoing upfront surgery (n = 182). We extracted radiomic features from the four phases of dynamic contrast-enhanced magnetic resonance imaging, and randomly divided the patients into training (n = 137) and validation (n = 45) cohorts. For predicting the immunophenotypes, radiomic models (RMs) that combined the four phases demonstrated superior performance to those derived from a single phase. For discriminating the inflamed tumor from the non-inflamed tumor, the feature-based combination model from the whole tumor (RM-wholeFC) showed high performance in both training (area under the receiver operating characteristic curve [AUC] = 0.973) and validation cohorts (AUC = 0.985). Similarly, the feature-based combination model from the peripheral tumor (RM-periFC) discriminated between immune-desert and excluded tumors with high performance in both training (AUC = 0.993) and validation cohorts (AUC = 0.984). Both RM-wholeFC and RM-periFC demonstrated good to excellent performance for every molecular subtype. Furthermore, in patients who underwent neoadjuvant chemotherapy (n = 64), pre-treatment images showed that tumors exhibiting complete response to neoadjuvant chemotherapy had significantly higher scores from RM-wholeFC and lower scores from RM-periFC. Our RMs predicted the immunophenotype of breast cancer based on the spatial distribution of CD8+ T cells with high accuracy. This approach can be used to stratify patients non-invasively based on the status of the tumor-immune microenvironment.

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A model combining pretreatment MRI radiomic features and tumor-infiltrating lymphocytes to predict response to neoadjuvant systemic therapy in triple-negative breast cancer

Cited by 22 publications

References 39 publications

Predictive and prognostic values of tumor infiltrating lymphocytes in breast cancers treated with neoadjuvant chemotherapy: A meta-analysis

Predictive and prognostic values of tumor infiltrating lymphocytes in breast cancers treated with neoadjuvant chemotherapy: A meta-analysis

Predictive value of stromal tumor-infiltrating lymphocytes in patients with breast cancer treated with neoadjuvant chemotherapy: A meta-analysis

Radiomic models based on magnetic resonance imaging predict the spatial distribution of CD8+ tumor-infiltrating lymphocytes in breast cancer

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