Jordana Jampel

DocwireNews

In the 10-year follow-up analysis of the ShortHER randomized clinical trial, researchers examined whether the level of tumor-infiltrating lymphocytes (TILs) is associated with survival outcomes in patients with ERBB2 (formerly HER2)–positive early breast cancer and whether this can guide adjuvant treatment de-escalation. Results were <a href="https://jamanetwork.com/journals/jamaoncology/fullarticle/2830196">published</a> in JAMA Oncology.
In the multicentric Italian ShortHER trial, patients were randomly assigned to either 3 courses of taxanes combined with trastuzumab for 9 weeks followed by 3 courses of reduced-dose anthracycline-based chemotherapy (short arm) or 4 cycles of anthracycline-based chemotherapy followed by 4 courses of taxanes combined with trastuzumab for 1 year (long arm).
Of the 1,253 patients enrolled in this trial, 866 of them (median age, 56 years; interquartile range, 48-64 years) had evaluable TILs. In Cox models with relevant factors, each 5% increase in TIL increment was associated with improved distant disease-free survival (DDFS) (hazard ratio [HR], 0.87; 95% CI, 0.80-0.95; P=0.001) and overall survival (OS) (HR, 0.89; 95% CI, 0.81-0.98; P=0.01).
The 10-year OS rates were:
<ul>
<li>3% for patients with TILs ≥20%</li>
<li>3% for patients with TILs ≥30%</li>
<li>1% for patients with TILs ≥50%</li>
</ul>
Patients with TILs &lt;20% showed a better outcome in the long arm than in the short arm (10-year DDFS, 88.7% vs. 81.0%), whereas for patients with TILs ≥20%, the 10-year DDFS was 87.1% in the long arm versus 92.2% in the short arm (P for interaction=0.01).
Patients with ≥20% TILs had a 10-year OS rate of 89.3% in the long arm versus 93.1% in the short arm (HR, 0.36; 95% CI, 0.10-1.36); patients with &lt;20% TILs had a 10-year OS rate of 91.3% in the long arm versus 86.9% in the short arm (HR, 1.36; 95% CI, 0.82-2.23; P for interaction=0.06).
According to these data, TILs can serve as a biomarker to identify patients with ERBB2-positive early breast cancer who may safely undergo de-escalated adjuvant therapy without compromising long-term survival outcomes.
The researchers concluded that their follow-up analysis of the ShortHER trial is likely “the first demonstration of an independent effect of TILs in terms of OS for patients with ERBB2-positive early breast cancer treated with adjuvant chemotherapy and anti-ERBB2 therapy.” They pointed out that “Patients with TILs 20% or higher who de-escalated trastuzumab duration and chemotherapy dose were not exposed to an excess risk of distant relapse or death.”
Source
<a href="https://jamanetwork.com/journals/jamaoncology/fullarticle/2830196">JAMA Oncology</a>

In the 10-year follow-up analysis of the ShortHER randomized clinical trial, researchers examined whether the level of tumor-infiltrating lymphocytes (TILs) is associated with survival outcomes in patients with ERBB2 (formerly HER2)–positive early breast cancer and whether this can guide adjuvant treatment de-escalation. Results were <a href="https://jamanetwork.com/journals/jamaoncology/fullarticle/2830196">published</a> in JAMA Oncology.In the multicentric Italian ShortHER trial, patients were randomly assigned to either 3 courses of taxanes combined with trastuzumab for 9 weeks followed by 3 courses of reduced-dose anthracycline-based chemotherapy (short arm) or 4 cycles of anthracycline-based chemotherapy followed by 4 courses of taxanes combined with trastuzumab for 1 year (long arm).Of the 1,253 patients enrolled in this trial, 866 of them (median age, 56 years; interquartile range, 48-64 years) had evaluable TILs. In Cox models with relevant factors, each 5% increase in TIL increment was associated with improved distant disease-free survival (DDFS) (hazard ratio [HR], 0.87; 95% CI, 0.80-0.95; P=0.001) and overall survival (OS) (HR, 0.89; 95% CI, 0.81-0.98; P=0.01).The 10-year OS rates were:<ul>
<li>3% for patients with TILs ≥20%</li>
<li>3% for patients with TILs ≥30%</li>
<li>1% for patients with TILs ≥50%</li>
</ul>Patients with TILs &lt;20% showed a better outcome in the long arm than in the short arm (10-year DDFS, 88.7% vs. 81.0%), whereas for patients with TILs ≥20%, the 10-year DDFS was 87.1% in the long arm versus 92.2% in the short arm (P for interaction=0.01).Patients with ≥20% TILs had a 10-year OS rate of 89.3% in the long arm versus 93.1% in the short arm (HR, 0.36; 95% CI, 0.10-1.36); patients with &lt;20% TILs had a 10-year OS rate of 91.3% in the long arm versus 86.9% in the short arm (HR, 1.36; 95% CI, 0.82-2.23; P for interaction=0.06).According to these data, TILs can serve as a biomarker to identify patients with ERBB2-positive early breast cancer who may safely undergo de-escalated adjuvant therapy without compromising long-term survival outcomes.The researchers concluded that their follow-up analysis of the ShortHER trial is likely “the first demonstration of an independent effect of TILs in terms of OS for patients with ERBB2-positive early breast cancer treated with adjuvant chemotherapy and anti-ERBB2 therapy.” They pointed out that “Patients with TILs 20% or higher who de-escalated trastuzumab duration and chemotherapy dose were not exposed to an excess risk of distant relapse or death.”Source<a href="https://jamanetwork.com/journals/jamaoncology/fullarticle/2830196">JAMA Oncology</a>

DocWire News Editors

Single-Dose Baloxavir Reduces Flu Transmission Risk

Infectious Disease

Leah Lawrence

Benefit of Ambroxol on Parkison Disease Dementia Unclear

Dementia

Lauren Dembeck, PhD

Novel Risk Prediction Model for Gastroesophageal Reflux Disease

Gastroenterology

Latest News

Tumor-Infiltrating Lymphocyte Analysis for Survival Outcomes in Early ERBB2-Positive Breast Cancer

HER2 Breast Cancer

TILs can serve as a biomarker to identify patients with ERBB2-positive early breast cancer who can reduce adjuvant therapy.

About Us

Editorial Policy

Advertising

Contact Us

eNewsletters

Contribute

Career Center

MashupMD

Blood Cancers Today

Cancer Nursing Today

GU Oncology Now

Urban Health Today

Anemia

Deep Vein Thrombosis

Essential Thrombocythemia

Hemophilia

Immune Thrombocytopenic Purpura

Myelodysplastic Syndromes

Myelofibrosis

Myeloproliferative Neoplasms

Polycythemia Vera

Pulmonary Embolism

Sickle Cell Disease

Thrombocytopenia

Thrombophilia

Thrombosis

Thrombotic Thrombocytopenic Purpura

Venous Thromboembolism

von Willebrand Disease

Heme Today

Acute Kidney Injury

ADPKD

Anemia and Kidney Disease

Chronic Kidney Disease

COVID-19 and Kidney Disease

Diabetes and Hypertension

End-Stage Renal Disease

Gout

Hyperkalemia

IgAN

Kidney Transplantation

Metabolic Acidosis

Nephrology Times

HR Breast Cancer

Triple-Negative Breast Cancer

Genetics & Breast Cancer

Breast Cancers Today

Diabetes

Obesity

Metabolic Care Today

Atherosclerotic Disease

Atrial Fibrillation

Heart Failure

Hypertension

Interventional Cardiology

Lipid Management

Practice Tips With Dr. Lichaa

Preventive Cardiology

Stroke

Cardiology

Breast Cancer

Gynecologic Cancer

Head and Neck Cancer

Skin Cancer

Oncology

Sleep

Urology

Ophthalmology

— Demodex Blepharitis

Neurology

Rheumatology

Pulmonology

Infectious Diseases

— HIV

Health and Wellness

Lupus

Future of Medicine

Orthopedics

Pharmacology

Career News

More

Conferences

CardioNerds

The Sleep Source With Dr. Morse

Rheumatology Rounds With Dr. Maheswaranathan

Partners

Expert Interviews

Subscribe