by Xiao-Ran Liu, Jian-Jun Yu, Guo-Hong Song, Li-Jun Di,
Han-Fang Jiang, Ying Yan, Xu Liang, Ru-Yan Zhang, Ran Ran, Jing Wang, Han Bai,
Shi-Dong Jia, Hui-Ping Li
The Breast: Open
Access, November 11, 2020
Highlights
•High pCTL level predicts shorter first-line PFS in
HER2-positive patients receiving anti-HER2 based regimens.
•The predictive role of pCTL level found in HER2-positive
patients was not applicable in hormone-positive and triple-negative breast
cancer patients.
•High level of pCTL was associated with immunosuppressive
status and FGFR1 mutations in HER2-positive breast cancer patients.
Abstract
Background
The role of peripheral blood lymphocyte (pBL) in breast
cancer has long been studied. However, the predictive role of pBL in advanced
breast cancer (ABC) is poorly understood.
Methods
A total of 303 patients with ABC were consecutively
recruited at our center between January 2015 and September 2019. At baseline,
pBL subtypes were detected in all patients with 229 blood samples available for
circulating tumor DNA (ctDNA) detection. pBL was analyzed through flow
cytometry. ctDNA-based gene mutations were detected using next generation
sequencing. The cutoff value of pCTL was estimated by X-tile software.
Progression free survival (PFS) was estimated by Kaplan-Meier curve and Cox
hazard proportion regression model, with difference detection by log-rank test.
Results
Median follow-up time of the study was 21.0 months. The
median age of diagnosis was 52.0 years. Among the pBL subtypes, only pCTL level
was found predictive for PFS in the HER2+ patients whom received anti-HER2
therapy (13.1 vs. 5.6 months, P = 0.001). However, the predictive
role of pCTL was not found in HR-positive (P = 0.716) and TNBC (P =
0.202). pCTL high associated with suppressive immune indictors including lower
CD4/CD8 ratio (P = 0.004) and high level of Treg cell (P = 0.004).
High occurrence of FGFR1 amplification which has been reported as immune
suppressor was also found in HER2+ patients with pCTL high (22.2% vs.
4.3%, P = 0.048).
Conclusions
Higher pCTLs level associated with shorter PFS and FGFR1
mutation in HER2+ ABC patients.
