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Programmed death ligand 1 expression in triple‐negative breast cancer is associated with tumour‐infiltrating lymphocytes and improved outcome
Author(s) -
Beckers Rhian K,
Selinger Christina I,
Vilain Ricardo,
Madore Jason,
Wilmott James S,
Harvey Kate,
Holliday Anne,
Cooper Caroline L,
Robbins Elizabeth,
Gillett David,
Kennedy Catherine W,
Gluch Laurence,
Carmalt Hugh,
Mak Cindy,
Warrier Sanjay,
Gee Harriet E,
Chan Charles,
McLean Anna,
Walker Emily,
McNeil Catriona M,
Beith Jane M,
Swarbrick Alexander,
Scolyer Richard A,
O'Toole Sandra A
Publication year - 2016
Publication title -
histopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.626
H-Index - 124
eISSN - 1365-2559
pISSN - 0309-0167
DOI - 10.1111/his.12904
Subject(s) - medicine , breast cancer , triple negative breast cancer , stromal cell , immunohistochemistry , oncology , lymphovascular invasion , biomarker , cancer , pathology , programmed cell death , tumor infiltrating lymphocytes , cancer research , immunotherapy , apoptosis , biology , metastasis , biochemistry
Aims Triple‐negative breast cancer ( TNBC ) patients generally have a poor outcome; there is a pressing need to identify more effective therapeutic strategies. Clinical trials targeting programmed death 1/programmed death ligand 1 ( PD 1/ PDL 1) in melanoma and non‐small‐cell lung cancer have reported high response rates, and tumoral PDL 1 expression has been suggested as a potential biomarker to enrich for patient response to these treatments. There are only very limited data to date reporting the expression of PDL 1 in TNBC . Methods and results PDL 1 immunohistochemistry was performed on 161 primary TNBC s and assessed in the tumour as well as immune cells in the stromal compartment. PDL 1 expression was very common in TNBC , expressed in the tumour cell membrane (64%), cytoplasm (80%) and stromal (93%) cellular compartments. Cytoplasmic tumoral expression of PDL 1 was associated with a lower risk of breast cancer‐specific death [hazard ratio ( HR ) 0.45, P = 0.035] while stromal PDL 1 expression was associated with a lower rate of deaths from all causes ( HR 0.305, P = 0.0042). Membranous expression of PDL 1 was not associated with outcome. While both PDL 1 expression and tumour‐infiltrating lymphocytes were associated with a better outcome, only lymphovascular invasion and high tumour‐infiltrating lymphocytes were independently prognostic for breast cancer‐specific death. Conclusion While PDL 1 expression is frequent in TNBC , it was not independently prognostic. There were differences in outcome depending on the cellular compartment of PDL 1 expression. These data provide further impetus for investigating the utility of immune checkpoint therapies in TNBC , given the clinical significance of tumour‐infiltrating lymphocytes ( TIL s) and PDL 1 expression in this cohort.