Cancer Research Immune cells can predict chances of recovery in breast cancer

Prognosis in breast cancer: Immune cells predict chances of recovery

Breast cancer, also called breast cancer, is the most common malignant tumor in women. In Germany alone, up to 70,000 new cases are counted each year. Researchers have now discovered that immune cells decide on survival in certain forms of breast cancer. In addition, they also predict the benefits of chemotherapy.

The most common malignant tumor in women

According to projections by the Robert Koch Institute in Berlin, around 65,500 women in Germany are diagnosed with breast cancer every year, "writes the German Cancer Aid. Breast cancer is the most common malignant tumor in women. In general, the sooner the tumor is discovered and the more precisely it can be diagnosed, the chances of recovery increase. In certain types of breast cancer, the immune cells decide on the chances of survival, as German researchers have now found out. These cells also predict the benefits of chemotherapy.

Researchers have found that certain types of breast cancer make immune cells decide on survival. In addition, they also predict the benefits of chemotherapy. (Image: Sven Bähren / fotolia.com)

Immune cells decide on the chances of survival

When immune cells invade the tumor, it is generally considered a good sign because the body's own defense against cancer appears to be working.

In certain types of breast cancer, immune cells, called tumor infiltrating lymphocytes (TILs), decide on the chances of survival and also predict the benefits of chemotherapy.

This shows the largest metastatic study to date on the TIL content of scientists from the German Consortium for Translational Cancer Research (DKTK) at the Charité - Universitätsmedizin Berlin in cooperation with the German Breast Group.

The results of the study were recently published in the journal "The Lancet Oncology".

Decision for or against chemotherapy

The decision for or against chemotherapy often proves difficult in breast cancer. Even before the operation, the treatment can reduce the size of a malignant tumor so that less tissue needs to be removed.

But it is also associated with serious side effects, so that doctors have to balance the benefits and risks for the patient.

The new study describes so-called tumor infiltrating lymphocytes (TIL) as an important factor in predicting the chances of recovery and the benefits of chemotherapy. Many TILs mean that chemotherapy will be especially effective against the tumors.

Sign of good chances of recovery

"In particular, in fast-growing breast tumors, immune cells that are detectable in the tumor, a sign of good chances of recovery, the tumor is then visible to the immune system," said Carsten Denkert from the Institute of Pathology Charité in a statement.

Denkert, one of the DKTK breast cancer specialists, and his colleagues wanted to know how reliably TIL content can be used as a biomarker for different forms of breast cancer, and which immune cell types are the key indicators.

The fact that there are grave differences here is shown by the most comprehensive study to date on immune cell content in breast cancer.

Scientists and physicians analyzed the proportion of tumor-infiltrating immune cells in 3,771 tissue samples from patients in six clinical breast cancer studies. All women received chemotherapy before surgery.

The study clearly showed that a high TIL level is accompanied by a better response to therapy and good chances of survival in patients with the so-called triple-negative and HER2-positive breast cancer.

"In this situation, the chemotherapy and the immune system mutually support each other to fight the tumor," Denkert said.

TIL content with high prognostic value

However, the luminal subtype (hormone receptor-positive / HER2-negative) is quite different, as the study showed. Patients with this form of breast cancer showed lower TIL values ​​overall and here TILs were not associated with improved survival.

"We therefore assume that this type of breast cancer is based on a different immune response and the composition of the invading immune cells is different," Denkert summarizes.

Closer inspection reveals that macrophages that are part of the white blood cells in the tumor are a sign of a poor prognosis in the luminal breast cancer form.

A high proportion of antibody-producing B cells, on the other hand, correlated with good chances of survival.

"Our results show that the TIL content of some aggressive forms of breast cancer has high prognostic value in predicting which patients will benefit from chemotherapy," Denkert says.

To further improve the response, immunotherapy is currently being tested to additionally activate the immune system against the tumor.

In cooperation with the German Breast Group, biomarker investigations in the GeparNuevo clinical study will be carried out at DKTK Berlin in order to find out how immune cells can be used as markers for successful immunotherapy with so-called checkpoint inhibitors.

In future, TILs will be used as markers to better control breast cancer therapy for patients. (Ad)