Comparison of the tumor immune microenvironment phenotypes in different breast cancers after neoadjuvant therapy

Abstract Neoadjuvant therapy (NAT) treats early‐stage breast cancers, especially triple‐negative breast cancers (TNBCs). NAT improves pathological complete response (pCR) rates for different breast cancer patients. Recently, immune checkpoint inhibitors that target programmed death 1 (PD‐1) or progr...

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Main Authors: Mengxue Han, Jinze Li, Si Wu, Chun Wu, Yongqiang Yu, Yueping Liu
Format: Article
Language:English
Published: Wiley 2023-02-01
Series:Cancer Medicine
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Online Access:https://doi.org/10.1002/cam4.5207
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author Mengxue Han
Jinze Li
Si Wu
Chun Wu
Yongqiang Yu
Yueping Liu
author_facet Mengxue Han
Jinze Li
Si Wu
Chun Wu
Yongqiang Yu
Yueping Liu
author_sort Mengxue Han
collection DOAJ
description Abstract Neoadjuvant therapy (NAT) treats early‐stage breast cancers, especially triple‐negative breast cancers (TNBCs). NAT improves pathological complete response (pCR) rates for different breast cancer patients. Recently, immune checkpoint inhibitors that target programmed death 1 (PD‐1) or programmed death ligand 1 (PD‐L1) in combination with NAT have shown antitumor activity in patients with early breast cancer. However, the tumor immune microenvironment (TME) in different subtypes of breast cancers, like TNBC, hormone receptor‐positive (HR+), and human epidermal growth factor receptor 2 amplified (HER2+) and its changes by NAT remain to be fully characterized. We analyzed pre‐NAT tumor biopsies from TNBC (n = 27), HR+ (n = 24), and HER2+ (n = 30) breast cancer patients who received NAT, followed by surgery. The different immune makers (PD‐1, PD‐L1, CD3, and CD8) of tumor‐infiltrating lymphocytes (TILs) were identified with immunofluorescence‐based microenvironment analysis. TILs within cancer parenchyma (iTILs) and in cancer stroma (sTILs) were counted separately. We found that PD‐L1+ cells in tumor and stroma were significantly higher in TNBC patients than in others. PD‐L1+ sTILs were significantly higher in pCR than in non‐pCR patients of all the subtypes. The infiltration scores of B‐cell memory, T‐cell CD4+ memory activated, T‐cell follicular helper, and Macrophage M0 and M1 were relatively higher in TNBC patients, indicating immunoreactive TME in TNBC. Analysis of TCGA‐BRCA RNA‐seq indicated that PD‐L1 was highly expressed in TNBC patients compared with HR+ and HER2+ patients. Higher PD‐L1 expression in TNBC patients was associated with significantly longer overall survival (OS). Our results demonstrated that PD‐L1 expression level of iTILs and sTILs is highest in TNBC among breast cancers. TNBC patients had significantly different immunoreactive TME compared with HR+ and HER2+ patients, suggesting potentially favorable outcomes for immunotherapy in these patients. Also, PD‐L1+ could be a powerful predictor of pCR in TNBC patients after NAT.
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spelling doaj-art-b6e72c570e9c45ec9249bd35fb52f5842025-08-20T02:23:32ZengWileyCancer Medicine2045-76342023-02-011232906291710.1002/cam4.5207Comparison of the tumor immune microenvironment phenotypes in different breast cancers after neoadjuvant therapyMengxue Han0Jinze Li1Si Wu2Chun Wu3Yongqiang Yu4Yueping Liu5Department of Pathology The Fourth Hospital of Hebei Medical University Shijiazhuang ChinaDepartment of Pathology The Fourth Hospital of Hebei Medical University Shijiazhuang ChinaDepartment of Pathology The Fourth Hospital of Hebei Medical University Shijiazhuang ChinaDepartment of Pathology The Fourth Hospital of Hebei Medical University Shijiazhuang ChinaDepartment of Pathology The Fourth Hospital of Hebei Medical University Shijiazhuang ChinaDepartment of Pathology The Fourth Hospital of Hebei Medical University Shijiazhuang ChinaAbstract Neoadjuvant therapy (NAT) treats early‐stage breast cancers, especially triple‐negative breast cancers (TNBCs). NAT improves pathological complete response (pCR) rates for different breast cancer patients. Recently, immune checkpoint inhibitors that target programmed death 1 (PD‐1) or programmed death ligand 1 (PD‐L1) in combination with NAT have shown antitumor activity in patients with early breast cancer. However, the tumor immune microenvironment (TME) in different subtypes of breast cancers, like TNBC, hormone receptor‐positive (HR+), and human epidermal growth factor receptor 2 amplified (HER2+) and its changes by NAT remain to be fully characterized. We analyzed pre‐NAT tumor biopsies from TNBC (n = 27), HR+ (n = 24), and HER2+ (n = 30) breast cancer patients who received NAT, followed by surgery. The different immune makers (PD‐1, PD‐L1, CD3, and CD8) of tumor‐infiltrating lymphocytes (TILs) were identified with immunofluorescence‐based microenvironment analysis. TILs within cancer parenchyma (iTILs) and in cancer stroma (sTILs) were counted separately. We found that PD‐L1+ cells in tumor and stroma were significantly higher in TNBC patients than in others. PD‐L1+ sTILs were significantly higher in pCR than in non‐pCR patients of all the subtypes. The infiltration scores of B‐cell memory, T‐cell CD4+ memory activated, T‐cell follicular helper, and Macrophage M0 and M1 were relatively higher in TNBC patients, indicating immunoreactive TME in TNBC. Analysis of TCGA‐BRCA RNA‐seq indicated that PD‐L1 was highly expressed in TNBC patients compared with HR+ and HER2+ patients. Higher PD‐L1 expression in TNBC patients was associated with significantly longer overall survival (OS). Our results demonstrated that PD‐L1 expression level of iTILs and sTILs is highest in TNBC among breast cancers. TNBC patients had significantly different immunoreactive TME compared with HR+ and HER2+ patients, suggesting potentially favorable outcomes for immunotherapy in these patients. Also, PD‐L1+ could be a powerful predictor of pCR in TNBC patients after NAT.https://doi.org/10.1002/cam4.5207immune microenvironmentneoadjuvant therapyPD‐L1triple‐negative breast cancertumor‐infiltrating lymphocytes
spellingShingle Mengxue Han
Jinze Li
Si Wu
Chun Wu
Yongqiang Yu
Yueping Liu
Comparison of the tumor immune microenvironment phenotypes in different breast cancers after neoadjuvant therapy
Cancer Medicine
immune microenvironment
neoadjuvant therapy
PD‐L1
triple‐negative breast cancer
tumor‐infiltrating lymphocytes
title Comparison of the tumor immune microenvironment phenotypes in different breast cancers after neoadjuvant therapy
title_full Comparison of the tumor immune microenvironment phenotypes in different breast cancers after neoadjuvant therapy
title_fullStr Comparison of the tumor immune microenvironment phenotypes in different breast cancers after neoadjuvant therapy
title_full_unstemmed Comparison of the tumor immune microenvironment phenotypes in different breast cancers after neoadjuvant therapy
title_short Comparison of the tumor immune microenvironment phenotypes in different breast cancers after neoadjuvant therapy
title_sort comparison of the tumor immune microenvironment phenotypes in different breast cancers after neoadjuvant therapy
topic immune microenvironment
neoadjuvant therapy
PD‐L1
triple‐negative breast cancer
tumor‐infiltrating lymphocytes
url https://doi.org/10.1002/cam4.5207
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AT siwu comparisonofthetumorimmunemicroenvironmentphenotypesindifferentbreastcancersafterneoadjuvanttherapy
AT chunwu comparisonofthetumorimmunemicroenvironmentphenotypesindifferentbreastcancersafterneoadjuvanttherapy
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