Tumor immune microenvironment and response to neoadjuvant chemotherapy in hormone receptor/HER2+ early stage breast cancer Journal Article


Authors: Vanguri, R. S.; Fenn, K. M.; Kearney, M. R.; Wang, Q.; Guo, H.; Marks, D. K.; Chin, C.; Alcus, C. F.; Thompson, J. B.; Leu, C. S.; Hibshoosh, H.; Kalinsky, K. M.; Mathews, J. C.; Nadeem, S.; Hollmann, T. J.; Connolly, E. P.
Article Title: Tumor immune microenvironment and response to neoadjuvant chemotherapy in hormone receptor/HER2+ early stage breast cancer
Abstract: Background: Pathologic response at the time of surgery after neoadjuvant therapy for HER2 positive early breast cancer impacts both prognosis and subsequent adjuvant therapy. Comprehensive descriptions of the tumor microenvironment (TME) in patients with HER2 positive early breast cancer is not well described. We utilized standard stromal pathologist-assessed tumor infiltrating lymphocyte (TIL) quantification, quantitative multiplex immunofluorescence, and RNA-based gene pathway signatures to assess pretreatment TME characteristics associated pathologic complete response in patients with hormone receptor positive, HER2 positive early breast cancer treated in the neoadjuvant setting. Methods: We utilized standard stromal pathologist-assessed TIL quantification, quantitative multiplex immunofluorescence, and RNA-based gene pathway signatures to assess pretreatment TME characteristics associated pathologic complete response in 28 patients with hormone receptor positive, HER2 positive early breast cancer treated in the neoadjuvant setting. Results: Pathologist-assessed stromal TILs were significantly associated with pathologic complete response (pCR). By quantitative multiplex immunofluorescence, univariate analysis revealed significant increases in CD3+, CD3+CD8-FOXP3-, CD8+ and FOXP3+ T-cell densities as well as increased immune cell aggregates in pCR patients. In subsets of paired pre/post-treatment samples, we observed significant changes in gene expression signatures in non-pCR patients and significant decreases in CD8+ densities after treatment in pCR patients. No RNA based pathway signature was associated with pCR. Conclusion: TME characterization HER2 positive breast cancer patients revealed several stromal T-cell densities and immune cell aggregates associated with pCR. These results demonstrate the feasibility of these novel methods in TME evaluation and contribute to ongoing investigations of the TME in HER2+ early breast cancer to identify robust biomarkers to best identify patients eligible for systemic de-escalation strategies. © 2022
Keywords: breast cancer; tumor infiltrating lymphocytes; her2 positive; gene expression signatures; quantitative multiplex immunofluorescence
Journal Title: Clinical Breast Cancer
Volume: 22
Issue: 6
ISSN: 1526-8209
Publisher: Elsevier Inc.  
Date Published: 2022-08-01
Start Page: 538
End Page: 546
Language: English
DOI: 10.1016/j.clbc.2022.04.002
PUBMED: 35610143
PROVIDER: scopus
PMCID: PMC10266131
DOI/URL:
Notes: Article -- Export Date: 1 August 2022 -- Source: Scopus
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  1. Travis Jason Hollmann
    126 Hollmann
  2. James C Mathews
    13 Mathews
  3. Saad Nadeem
    50 Nadeem
  4. Rami Sesha Vanguri
    15 Vanguri