Value of Breast and Axillary Tumor-Infiltrating Lymphocytes for Response to Neoadjuvant Chemo-(Immuno)Therapy in Clinically Node-Positive Breast Cancer.

Authors

Melissa Lenaerts, Loes F S Kooreman, Florien J G van Amstel, Paul J van Diest, Sander M J van Kuijk, Ernest J T Luiten, Carmen C van der Pol, Linetta B Koppert, Janine M Simons, Marjolein L Smidt, REFINE study group, Thiemo J A van Nijnatten

Published in

Clinical breast cancer. Volume 26. Issue 11. Pages 17-24. Sep 17, 2026. Epub Sep 17, 2026.

Abstract

Accurate prediction of pathologic complete response (pCR) after neoadjuvant chemo-(immuno)therapy (NAC) is clinically relevant in clinically node-positive (cN+) breast cancer patients. This study evaluated the association of pre-NAC tumor-infiltrating lymphocytes (TILs) in the breast tumor and axillary lymph node metastases (ALNMs) with breast, axillary, and combined pCR. Second, correlations between pre-NAC breast tumor and ALNM TILs, and between pre- and post-NAC breast tumor TILs were analyzed.
This retrospective study included cN+ breast cancer patients treated with NAC from the prospective multicenter RISAS trial (NCT02800317). Pre-NAC breast tumor and ALNM TILs and post-NAC breast tumor TILs were centrally assessed and classified as low (< 10%), intermediate (10%-40%), or high (> 40%). Logistic regression, receiver operating characteristic curve, and Spearman's rank correlation analyses were performed.
Of 206 included patients, 29.6% (61/206) achieved breast pCR, 31.1% (64/206) axillary pCR and 23.3% (48/206) combined pCR. Increased breast tumor TILs were associated with stepwise higher breast (21.4%, 30.4%, 53.1%; P = .004), and axillary (25.0%, 30.4%, 53.1%; P = .014) pCR rates for low, intermediate, and high TIL levels. ALNM TILs were not associated with any pCR. Weak-to-moderate positive correlations were found between pre-NAC breast tumor and ALNM TILs (r_s = 0.36, P = .001) and pre- and post-NAC breast tumor TILs (r_s = 0.47, P < .001).
Pre-NAC breast tumor TILs were associated with breast and axillary pCR, whereas ALNM TILs were not predictive of any pCR in cN+ breast cancer patients treated with NAC. Weak-to-moderate positive correlations were found between pre-NAC breast tumor and ALNM TILs and pre- and post-NAC breast tumor TILs.

PMID:
42858602
Bibliographic data and abstract were imported from PubMed on 11 Oct 2026.

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