Cell-mediated immunity to tumor-associated antigens is a better predictor of survival in early stage breast cancer than stage, grade or lymph node status

Abstract

Cell-mediated immune (CMI) responses to tumor-associated antigens (TAA) in the early postoperative period were examined for correlations with disease recurrence and survival in a 13-year-prospective study of 77 stage 1 and 2 breast cancer patients treated with modified radical or radical mastectomy alone. Among the 21 patients who had positive lymphoproliferative tests using patients' peripheral blood mononuclear cells and autologous TAA of breast cancer cells, only one died from metastatic disease (5%). Among the 56 patients who had a negative test, 23 died from metastatic disease (41%). This difference is statistically significant (p = 0.002) Three other risk factors including tumor size, nodal status and cell differentiation patterns were also analyzed. When these three clinical-pathologic criteria were analyzed individually, none reliably predicted disease recurrence and survival. Nodal status was the most predictive clinical-pathologic risk factor, but was not significant (p = 0.089). The results of this study demonstrate the detection of CMI responses against autologous TAA by lymphoproliferative assays identifies a sub-set of stage 1 and 2 breast cancer patients who are at minimal risk of developing metastatic disease. This testing also identifies immunologically unreactive patients who are at risk for disease recurrence.

Identification of shared TCR sequences from T cells in human breast cancer using emulsion RT-PCR

“…Targeted immune-based therapies hold great promise toward improving breast cancer treatments (6,7). Studies have examined the immune phenotype of breast cancer tumor-infiltrating lymphocytes (TILs), suggesting that activated nonsuppressive T cells are of most benefit (8). Further assessment of the TIL repertoire has broad implications for breast cancer therapies in antigen discovery, cancer vaccines, and adoptive cell therapies (7).…”

Cancer Immunothearapy More than Vaccines “Psychoneuro-Immunooncology: Cancer, the Host, and the Surgeon”

“…After tumor escape and local tumor growth (CMI) may still contribute to systemic control of cancer by controlling macrometastatic disease and eradiating residual disease after surgical removal of the primary tumor. This is supported by the evidence from clinical studies reporting that immune competence at the time of cancer treatment is an independent prognostic indicator of disease free survival [5][6][7]. Non-immunological factors can promote metastasis after surgery.…”

Impact of anesthesia for cancer surgery: Continuing Professional Development

“…63 Outcome data were compared with the patients' CMI responses to autologous tumourassociated antigens (TAA; proteins that are expressed differently in cancer cells vs normal cells) in the early post-operative period. Twenty-one patients had a positive cell-mediated immune response to autologous TAA.…”

“…63 Le pronostic a été comparé aux réponses de l'IMC chez des patientes aux antigènes autologues associés à la tumeur (TAA; des protéines qui sont exprimées différemment dans les cellules cancéreuses par rapport aux cellules normales) au cours de la période postopératoire précoce. Vingt et une (21) patientes ont présenté une réponse de l'IMC positive pour les TAA autologues.…”