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Erschienen in: Die Pathologie 6/2018

16.10.2018 | Mammakarzinom | Schwerpunkt: Immunpathologie

Standardisierte Bestimmung tumorinfiltrierender Lymphozyten beim Mammakarzinom

Ein prognostischer Marker für die histologische Diagnostik

verfasst von: Prof. Dr. C. Denkert, S. Loibl, J. Budczies, S. Wienert, F. Klauschen

Erschienen in: Die Pathologie | Ausgabe 6/2018

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Zusammenfassung

Hintergrund

Tumorinfiltrierende Lymphozyten (TIL) wurden in verschiedenen klinischen Studienkohorten als Prognoseparameter für das Mammakarzinom identifiziert.

Ziel der Arbeit

Ziel dieser Übersicht ist es, einen Überblick über den Stand der klinischen und der analytischen Validierung der TILs beim Mammakarzinom zu geben.

Material und Methoden

Standardisierte Guidelines der internationalen TIL Working Group sowie klinische und translationale Untersuchungen werden zusammengefasst.

Ergebnisse und Diskussion

Mammakarzinome mit einem erhöhten TIL-Infiltrat haben eine verbesserte Ansprechrate auf eine neoadjuvante Chemotherapie. Triplenegative und HER2-positive Mammakarzinome mit einem vermehrten TIL-Infiltrat weisen eine bessere Prognose auf. TILs sind ein neuer Prognoseparameter beim Mammakarzinom, der in der Routinediagnostik bestimmbar ist.
Literatur
1.
Zurück zum Zitat Moore OS Jr, Foote FW Jr. (1949) The relatively favorable prognosis of medullary carcinoma of the breast. Cancer 2(4):635–642CrossRef Moore OS Jr, Foote FW Jr. (1949) The relatively favorable prognosis of medullary carcinoma of the breast. Cancer 2(4):635–642CrossRef
2.
Zurück zum Zitat Lakhani SR, Ellis IO, Schnitt SJ, Tan PH, van de Vijver MJ (Hrsg) (2012) IARC classifications, 4. Aufl. WHO classification of tumours of the breast, Bd. 4 Lakhani SR, Ellis IO, Schnitt SJ, Tan PH, van de Vijver MJ (Hrsg) (2012) IARC classifications, 4. Aufl. WHO classification of tumours of the breast, Bd. 4
3.
Zurück zum Zitat Rigaud C, Theobald S, Noël P, Badreddine J, Barlier C, Delobelle A et al (1993) Medullary carcinoma of the breast. A multicenter study of its diagnostic consistency. Arch Pathol Lab Med 117(10):1005–1008PubMed Rigaud C, Theobald S, Noël P, Badreddine J, Barlier C, Delobelle A et al (1993) Medullary carcinoma of the breast. A multicenter study of its diagnostic consistency. Arch Pathol Lab Med 117(10):1005–1008PubMed
4.
Zurück zum Zitat Denkert C, von Minckwitz G, Darb-Esfahani S, Lederer B, Heppner BI, Weber KE et al (2018) Tumour-infiltrating lymphocytes and prognosis in different subtypes of breast cancer: a pooled analysis of 3771 patients treated with neoadjuvant therapy. Lancet Oncol 19(1):40–50CrossRef Denkert C, von Minckwitz G, Darb-Esfahani S, Lederer B, Heppner BI, Weber KE et al (2018) Tumour-infiltrating lymphocytes and prognosis in different subtypes of breast cancer: a pooled analysis of 3771 patients treated with neoadjuvant therapy. Lancet Oncol 19(1):40–50CrossRef
5.
Zurück zum Zitat Galluzzi L, Buqué A, Kepp O, Zitvogel L, Kroemer G (2017) Immunogenic cell death in cancer and infectious disease. Nat Rev Immunol 17(2):97–111CrossRef Galluzzi L, Buqué A, Kepp O, Zitvogel L, Kroemer G (2017) Immunogenic cell death in cancer and infectious disease. Nat Rev Immunol 17(2):97–111CrossRef
6.
Zurück zum Zitat Budczies J, Bockmayr M, Denkert C, Klauschen F, Lennerz JK, Györffy B et al (2015) Classical pathology and mutational load of breast cancer – integration of two worlds. J Pathol Clin Res 1(4):225–238CrossRefPubMedCentral Budczies J, Bockmayr M, Denkert C, Klauschen F, Lennerz JK, Györffy B et al (2015) Classical pathology and mutational load of breast cancer – integration of two worlds. J Pathol Clin Res 1(4):225–238CrossRefPubMedCentral
7.
Zurück zum Zitat Galluzzi L, Vitale I, Aaronson SA, Abrams JM, Adam D, Agostinis P et al (2018) Molecular mechanisms of cell death: recommendations of the Nomenclature Committee on Cell Death 2018. Cell Death Differ 25(3):486–541CrossRefPubMedCentral Galluzzi L, Vitale I, Aaronson SA, Abrams JM, Adam D, Agostinis P et al (2018) Molecular mechanisms of cell death: recommendations of the Nomenclature Committee on Cell Death 2018. Cell Death Differ 25(3):486–541CrossRefPubMedCentral
8.
Zurück zum Zitat Denkert C, Loibl S, Müller BM, Eidtmann H, Schmitt WD, Eiermann W et al (2013) Ki67 levels as predictive and prognostic parameters in pretherapeutic breast cancer core biopsies: a translational investigation in the neoadjuvant GeparTrio trial. Ann Oncol 24(11):2786–2793CrossRef Denkert C, Loibl S, Müller BM, Eidtmann H, Schmitt WD, Eiermann W et al (2013) Ki67 levels as predictive and prognostic parameters in pretherapeutic breast cancer core biopsies: a translational investigation in the neoadjuvant GeparTrio trial. Ann Oncol 24(11):2786–2793CrossRef
9.
Zurück zum Zitat Denkert C, Loibl S, Noske A, Roller M, Müller BM, Komor M et al (2010) Tumor-associated lymphocytes as an independent predictor of response to neoadjuvant chemotherapy in breast cancer. J Clin Oncol 28(1):105–113CrossRef Denkert C, Loibl S, Noske A, Roller M, Müller BM, Komor M et al (2010) Tumor-associated lymphocytes as an independent predictor of response to neoadjuvant chemotherapy in breast cancer. J Clin Oncol 28(1):105–113CrossRef
10.
Zurück zum Zitat Salgado R, Denkert C, Demaria S, Sirtaine N, Klauschen F, Pruneri G et al (2015) International TILs Working Group 2014. The evaluation of tumor-infiltrating lymphocytes (TILs) in breast cancer: recommendations by an International TILs Working Group 2014. Ann Oncol 26(2):259–271CrossRef Salgado R, Denkert C, Demaria S, Sirtaine N, Klauschen F, Pruneri G et al (2015) International TILs Working Group 2014. The evaluation of tumor-infiltrating lymphocytes (TILs) in breast cancer: recommendations by an International TILs Working Group 2014. Ann Oncol 26(2):259–271CrossRef
11.
Zurück zum Zitat Dieci MV, Radosevic-Robin N, Fineberg S, van den Eynden G, Ternes N, Penault-Llorca F, International Immuno-Oncology Biomarker Working Group on Breast Cancer, – (2017) Update on tumor-infiltrating lymphocytes (TILs) in breast cancer, including recommendations to assess TILs in residual disease after neoadjuvant therapy and in carcinoma in situ. Semin Cancer Biol 52(Pt 2):16–25. (A report of the International Immuno-Oncology Biomarker Working Group on Breast Cancer). https://doi.org/10.1016/j.semcancer.2017.10.003 PubMed Dieci MV, Radosevic-Robin N, Fineberg S, van den Eynden G, Ternes N, Penault-Llorca F, International Immuno-Oncology Biomarker Working Group on Breast Cancer, – (2017) Update on tumor-infiltrating lymphocytes (TILs) in breast cancer, including recommendations to assess TILs in residual disease after neoadjuvant therapy and in carcinoma in situ. Semin Cancer Biol 52(Pt 2):16–25. (A report of the International Immuno-Oncology Biomarker Working Group on Breast Cancer). https://​doi.​org/​10.​1016/​j.​semcancer.​2017.​10.​003 PubMed
13.
Zurück zum Zitat Hendry S, Salgado R, Gevaert T, Russell PA, John T, Thapa B et al (2017) Assessing tumor-infiltrating lymphocytes in solid tumors: a practical review for pathologists and proposal for a standardized method from the international Immunooncology Biomarkers working group. Adv Anat Pathol 24(5):235–251 (Part 1: assessing the host immune response, TILs in invasive breast carcinoma and ductal carcinoma in situ, metastatic tumor deposits and areas for further research)CrossRefPubMedCentral Hendry S, Salgado R, Gevaert T, Russell PA, John T, Thapa B et al (2017) Assessing tumor-infiltrating lymphocytes in solid tumors: a practical review for pathologists and proposal for a standardized method from the international Immunooncology Biomarkers working group. Adv Anat Pathol 24(5):235–251 (Part 1: assessing the host immune response, TILs in invasive breast carcinoma and ductal carcinoma in situ, metastatic tumor deposits and areas for further research)CrossRefPubMedCentral
14.
Zurück zum Zitat Hendry S, Salgado R, Gevaert T, Russell PA, John T, Thapa B et al (2017) Assessing tumor-infiltrating lymphocytes in solid tumors: a practical review for pathologists and proposal for a standardized method from the international Immuno-oncology Biomarkers working group. Adv Anat Pathol 24(6):311–335 (Part 2: TILs in melanoma, gastrointestinal tract carcinomas, non-small cell lung carcinoma and Mesothelioma, Endometrial and ovarian carcinomas, squamous cell carcinoma of the head and neck, genitourinary carcinomas, and primary brain tumors)CrossRef Hendry S, Salgado R, Gevaert T, Russell PA, John T, Thapa B et al (2017) Assessing tumor-infiltrating lymphocytes in solid tumors: a practical review for pathologists and proposal for a standardized method from the international Immuno-oncology Biomarkers working group. Adv Anat Pathol 24(6):311–335 (Part 2: TILs in melanoma, gastrointestinal tract carcinomas, non-small cell lung carcinoma and Mesothelioma, Endometrial and ovarian carcinomas, squamous cell carcinoma of the head and neck, genitourinary carcinomas, and primary brain tumors)CrossRef
15.
Zurück zum Zitat Dowsett M, Nielsen TO, A’Hern R, Bartlett J, Coombes RC, Cuzick J et al (2011) International Ki-67 in Breast Cancer Working Group. Assessment of Ki67 in breast cancer: recommendations from the International Ki67 in Breast Cancer working group. J Natl Cancer Inst 103(22):1656–1664CrossRefPubMedCentral Dowsett M, Nielsen TO, A’Hern R, Bartlett J, Coombes RC, Cuzick J et al (2011) International Ki-67 in Breast Cancer Working Group. Assessment of Ki67 in breast cancer: recommendations from the International Ki67 in Breast Cancer working group. J Natl Cancer Inst 103(22):1656–1664CrossRefPubMedCentral
16.
Zurück zum Zitat Polley MY, Leung SC, McShane LM, Gao D, Hugh JC, Mastropasqua MG et al (2013) International Ki67 in Breast Cancer Working Group of the Breast International Group and North American Breast Cancer Group. An international Ki67 reproducibility study. J Natl Cancer Inst 105(24):1897–1906CrossRefPubMedCentral Polley MY, Leung SC, McShane LM, Gao D, Hugh JC, Mastropasqua MG et al (2013) International Ki67 in Breast Cancer Working Group of the Breast International Group and North American Breast Cancer Group. An international Ki67 reproducibility study. J Natl Cancer Inst 105(24):1897–1906CrossRefPubMedCentral
18.
Zurück zum Zitat Klauschen F, Wienert S, Schmitt WD, Loibl S, Gerber B, Blohmer JU et al (2015) Standardized Ki67 diagnostics using automated scoring – clinical validation in the Gepartrio breast cancer study. Clin Cancer Res 21(16):3651–3657CrossRef Klauschen F, Wienert S, Schmitt WD, Loibl S, Gerber B, Blohmer JU et al (2015) Standardized Ki67 diagnostics using automated scoring – clinical validation in the Gepartrio breast cancer study. Clin Cancer Res 21(16):3651–3657CrossRef
19.
Zurück zum Zitat Denkert C, Wienert S, Poterie A, Loibl S, Budczies J, Badve S et al (2016) Standardized evaluation of tumor-infiltrating lymphocytes in breast cancer: results of the ring studies of the international immuno-oncology biomarker working group. Mod Pathol 29(10):1155–1164CrossRef Denkert C, Wienert S, Poterie A, Loibl S, Budczies J, Badve S et al (2016) Standardized evaluation of tumor-infiltrating lymphocytes in breast cancer: results of the ring studies of the international immuno-oncology biomarker working group. Mod Pathol 29(10):1155–1164CrossRef
21.
Zurück zum Zitat Curigliano G, Burstein HJ, Winer PE, Gnant M, Dubsky P, Loibl S et al (2017) De-escalating and escalating treatments for early-stage breast cancer: the St. Gallen International Expert Consensus Conference on the Primary Therapy of Early Breast Cancer 2017. Ann Oncol 28(8):1700–1712CrossRef Curigliano G, Burstein HJ, Winer PE, Gnant M, Dubsky P, Loibl S et al (2017) De-escalating and escalating treatments for early-stage breast cancer: the St. Gallen International Expert Consensus Conference on the Primary Therapy of Early Breast Cancer 2017. Ann Oncol 28(8):1700–1712CrossRef
23.
Zurück zum Zitat Dunbier AK, Ghazoui Z, Anderson H, Salter J, Nerurkar A, Osin P et al (2013) Molecular profiling of aromatase inhibitor-treated postmenopausal breast tumors identifies immune-related correlates of resistance. Clin Cancer Res 19(10):2775–2786CrossRef Dunbier AK, Ghazoui Z, Anderson H, Salter J, Nerurkar A, Osin P et al (2013) Molecular profiling of aromatase inhibitor-treated postmenopausal breast tumors identifies immune-related correlates of resistance. Clin Cancer Res 19(10):2775–2786CrossRef
24.
25.
Zurück zum Zitat Pagès F, Mlecnik B, Marliot F, Bindea G, Ou FS, Bifulco C et al (2018) International validation of the consensus Immunoscore for the classification of colon cancer: a prognostic and accuracy study. Lancet 391(10135):2128–2139CrossRef Pagès F, Mlecnik B, Marliot F, Bindea G, Ou FS, Bifulco C et al (2018) International validation of the consensus Immunoscore for the classification of colon cancer: a prognostic and accuracy study. Lancet 391(10135):2128–2139CrossRef
26.
Zurück zum Zitat Curtis C, Shah SP, Chin SF, Turashvili G, Rueda OM, Dunning MJ et al (2012) The genomic and transcriptomic architecture of 2,000 breast tumours reveals novel subgroups. Nature 486(7403):346–352 (Apr)CrossRefPubMedCentral Curtis C, Shah SP, Chin SF, Turashvili G, Rueda OM, Dunning MJ et al (2012) The genomic and transcriptomic architecture of 2,000 breast tumours reveals novel subgroups. Nature 486(7403):346–352 (Apr)CrossRefPubMedCentral
27.
Zurück zum Zitat Becht E, Giraldo NA, Lacroix L, Buttard B, Elarouci N, Petitprez F et al (2016) Estimating the population abundance of tissue-infiltrating immune and stromal cell populations using gene expression. Genome Biol 17(1):218CrossRefPubMedCentral Becht E, Giraldo NA, Lacroix L, Buttard B, Elarouci N, Petitprez F et al (2016) Estimating the population abundance of tissue-infiltrating immune and stromal cell populations using gene expression. Genome Biol 17(1):218CrossRefPubMedCentral
28.
Zurück zum Zitat Salgado R, Denkert C, Campbell C, Savas P, Nuciforo P, Aura C et al (2015) Tumor-infiltrating lymphocytes and associations with pathological complete response and event free survival in HER2-positive early-stage breast cancer treated with Lapatinib and Trastuzumab: a secondary analysis of the NeoALTTO trial. Jama Oncol 1(4):448–454CrossRefPubMedCentral Salgado R, Denkert C, Campbell C, Savas P, Nuciforo P, Aura C et al (2015) Tumor-infiltrating lymphocytes and associations with pathological complete response and event free survival in HER2-positive early-stage breast cancer treated with Lapatinib and Trastuzumab: a secondary analysis of the NeoALTTO trial. Jama Oncol 1(4):448–454CrossRefPubMedCentral
29.
Zurück zum Zitat Dieci MV, Mathieu MC, Guarneri V, Conte P, Delaloge S, Andre F, Goubar A (2015) Prognostic and predictive value of tumor-infiltrating lymphocytes in two phase III randomized adjuvant breast cancer trials. Ann Oncol 26(8):1698–1704CrossRefPubMedCentral Dieci MV, Mathieu MC, Guarneri V, Conte P, Delaloge S, Andre F, Goubar A (2015) Prognostic and predictive value of tumor-infiltrating lymphocytes in two phase III randomized adjuvant breast cancer trials. Ann Oncol 26(8):1698–1704CrossRefPubMedCentral
30.
Zurück zum Zitat Denkert C, von Minckwitz G, Brase JC, Sinn BV, Gade S, Kronenwett R et al (2015) Tumor-infiltrating lymphocytes and response to neoadjuvant chemotherapy with or without carboplatin in human epidermal growth factor receptor 2‑positive and triple-negative primary breast cancers. J Clin Oncol 33(9):983–991CrossRef Denkert C, von Minckwitz G, Brase JC, Sinn BV, Gade S, Kronenwett R et al (2015) Tumor-infiltrating lymphocytes and response to neoadjuvant chemotherapy with or without carboplatin in human epidermal growth factor receptor 2‑positive and triple-negative primary breast cancers. J Clin Oncol 33(9):983–991CrossRef
32.
Zurück zum Zitat Loi S, Sirtaine N, Piette F, Salgado R, Viale G, Van Eenoo F et al (2013) Prognostic and predictive value of tumor-infiltrating lymphocytes in a phase III randomized adjuvant breast cancer trial in node-positive breast cancer comparing the addition of docetaxel to doxorubicin with doxorubicin-based chemotherapy: BIG 02-98. J Clin Oncol 31(7):860–867CrossRef Loi S, Sirtaine N, Piette F, Salgado R, Viale G, Van Eenoo F et al (2013) Prognostic and predictive value of tumor-infiltrating lymphocytes in a phase III randomized adjuvant breast cancer trial in node-positive breast cancer comparing the addition of docetaxel to doxorubicin with doxorubicin-based chemotherapy: BIG 02-98. J Clin Oncol 31(7):860–867CrossRef
33.
Zurück zum Zitat Loi S, Michiels S, Salgado R, Sirtaine N, Jose V, Fumagalli D et al (2014) Tumor infiltrating lymphocytes are prognostic in triple negative breast cancer and predictive for trastuzumab benefit in early breast cancer: results from the FinHER trial. Ann Oncol 25(8):1544–1550CrossRef Loi S, Michiels S, Salgado R, Sirtaine N, Jose V, Fumagalli D et al (2014) Tumor infiltrating lymphocytes are prognostic in triple negative breast cancer and predictive for trastuzumab benefit in early breast cancer: results from the FinHER trial. Ann Oncol 25(8):1544–1550CrossRef
34.
Zurück zum Zitat Adams S, Gray RJ, Demaria S, Goldstein L, Perez EA, Shulman LN et al (2014) Prognostic value of tumor-infiltrating lymphocytes in triple-negative breast cancers from two phase III randomized adjuvant breast cancer trials: ECOG 2197 and ECOG 1199. J Clin Oncol 32(27):2959–2966CrossRefPubMedCentral Adams S, Gray RJ, Demaria S, Goldstein L, Perez EA, Shulman LN et al (2014) Prognostic value of tumor-infiltrating lymphocytes in triple-negative breast cancers from two phase III randomized adjuvant breast cancer trials: ECOG 2197 and ECOG 1199. J Clin Oncol 32(27):2959–2966CrossRefPubMedCentral
35.
Zurück zum Zitat Perez EA, Ballman KV, Tenner KS, Thompson EA, Badve SS, Bailey H, Baehner FL (2016) Association of Stromal tumor-infiltrating lymphocytes with recurrence-free survival in the N9831 Adjuvant trial in patients with early-stage HER2-positive breast cancer. Jama Oncol 2(1):56–64CrossRefPubMedCentral Perez EA, Ballman KV, Tenner KS, Thompson EA, Badve SS, Bailey H, Baehner FL (2016) Association of Stromal tumor-infiltrating lymphocytes with recurrence-free survival in the N9831 Adjuvant trial in patients with early-stage HER2-positive breast cancer. Jama Oncol 2(1):56–64CrossRefPubMedCentral
36.
Zurück zum Zitat Luen SJ, Salgado R, Fox S, Savas P, Eng-Wong J, Clark E et al (2017) Tumour-infiltrating lymphocytes in advanced HER2-positive breast cancer treated with pertuzumab or placebo in addition to trastuzumab and docetaxel: a retrospective analysis of the CLEOPATRA study. Lancet Oncol 18(1):52–62CrossRef Luen SJ, Salgado R, Fox S, Savas P, Eng-Wong J, Clark E et al (2017) Tumour-infiltrating lymphocytes in advanced HER2-positive breast cancer treated with pertuzumab or placebo in addition to trastuzumab and docetaxel: a retrospective analysis of the CLEOPATRA study. Lancet Oncol 18(1):52–62CrossRef
37.
Zurück zum Zitat Swisher SK, Wu Y, Castaneda CA, Lyons GR, Yang F, Tapia C et al (2016) Interobserver agreement between pathologists assessing tumor-infiltrating lymphocytes (TILs) in breast cancer using methodology proposed by the international TILs working group. Ann Surg Oncol 23(7):2242–2248CrossRef Swisher SK, Wu Y, Castaneda CA, Lyons GR, Yang F, Tapia C et al (2016) Interobserver agreement between pathologists assessing tumor-infiltrating lymphocytes (TILs) in breast cancer using methodology proposed by the international TILs working group. Ann Surg Oncol 23(7):2242–2248CrossRef
38.
Zurück zum Zitat Kojima YA, Wang X, Sun H, Compton F, Covinsky M, Zhang S (2018) Reproducible evaluation of tumor-infiltrating lymphocytes (TILs) using the recommendations of International TILs Working Group 2014. Ann Diagn Pathol 35:77–79CrossRef Kojima YA, Wang X, Sun H, Compton F, Covinsky M, Zhang S (2018) Reproducible evaluation of tumor-infiltrating lymphocytes (TILs) using the recommendations of International TILs Working Group 2014. Ann Diagn Pathol 35:77–79CrossRef
39.
Zurück zum Zitat Tramm T, Di Caterino T, Jylling AB, Lelkaitis G, Lænkholm AV, Ragó P et al (2018) Scientific Committee of Pathology, Danish Breast Cancer Group (DBCG). Standardized assessment of tumor-infiltrating lymphocytes in breast cancer: an evaluation of inter-observer agreement between pathologists. Acta Oncol 57(1):90–94CrossRef Tramm T, Di Caterino T, Jylling AB, Lelkaitis G, Lænkholm AV, Ragó P et al (2018) Scientific Committee of Pathology, Danish Breast Cancer Group (DBCG). Standardized assessment of tumor-infiltrating lymphocytes in breast cancer: an evaluation of inter-observer agreement between pathologists. Acta Oncol 57(1):90–94CrossRef
40.
Zurück zum Zitat Cabuk FK, Aktepe F, Kapucuoglu FN, Coban I, Sarsenov D, Ozmen V (2018) Interobserver reproducibility of tumor-infiltrating lymphocyte evaluations in breast cancer. Indian J Pathol Microbiol 61(2):181–186CrossRef Cabuk FK, Aktepe F, Kapucuoglu FN, Coban I, Sarsenov D, Ozmen V (2018) Interobserver reproducibility of tumor-infiltrating lymphocyte evaluations in breast cancer. Indian J Pathol Microbiol 61(2):181–186CrossRef
Metadaten
Titel
Standardisierte Bestimmung tumorinfiltrierender Lymphozyten beim Mammakarzinom
Ein prognostischer Marker für die histologische Diagnostik
verfasst von
Prof. Dr. C. Denkert
S. Loibl
J. Budczies
S. Wienert
F. Klauschen
Publikationsdatum
16.10.2018
Verlag
Springer Medizin
Erschienen in
Die Pathologie / Ausgabe 6/2018
Print ISSN: 2731-7188
Elektronische ISSN: 2731-7196
DOI
https://doi.org/10.1007/s00292-018-0530-y

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