Breast Cancer Coverage from Every Angle

2019 ASCO-SITC: Neoadjuvant Chemotherapy and the Immunologic Landscape in Breast Cancer

By: Lauren Harrison, MS
Posted: Monday, March 4, 2019

Immune cell subsets and activation status of these cells change as women with breast cancer undergo neoadjuvant chemotherapy. Karenia Landa, MD, of Duke University Medical Center in North Carolina, and her colleagues offered preliminary findings showing distinct trends in the number of circulating immune cells in different subpopulations within various tumor receptor subtypes. These findings were presented in a poster session at the 2019 American Society of Clinical Oncology (ASCO)–Society for Immunotherapy of Cancer (SITC) Clinical Immuno-Oncology Symposium in San Francisco (Abstract 7).

“These trends could serve to guide our therapies, allow for better patient selection, and predict treatment response in patients,” concluded the authors.

Samples from 11 patients with stages I to III breast cancer undergoing standard-of-care treatments were collected before and after neoadjuvant chemotherapy, after surgery, and at a 2-month follow-up. Flow-cytometry analysis at each time point revealed the percentage of circulating immune cells.

Patients with HER2-positive breast cancer had a gradual increase in all lymphocytes, with a decrease in CD20 B cells, but they had increasing numbers of CD3 and CD8 T cells through follow-up. Patients with HER2-negative tumors saw a gradual decline in the number of total lymphocytes, with a decline in CD3 T cells after neoadjuvant therapy and an increase in CD8 T cells after therapy. Triple-negative breast cancer also was associated with a gradual decrease in lymphocytes, with an initial decrease in CD3 T cells after therapy and a low CD8 T-cell count even at follow-up.

The investigators noted that 3 of the 11 patients achieved complete pathologic response to neoadjuvant chemotherapy (1 with HER2-positive disease, 1 with HER2-negative disease, 1 with triple-negative disease). These three patients had the highest percentage of CD56-positive natural killer cells during the course of treatment.

Disclosure: The study authors reported no conflicts of interest.

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