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Subpopulation composition of tumor-infiltrating lymphocytes in luminal breast cancer and its effect on effectiveness of neoadjuvant chemotherapy

Tumor-infiltrating lymphocytes (TILs) play a key role in the formation of anti-tumor immunity and, as studies have shown, can be one of the markers of treatment effectiveness and cancer prognosis. The aim was to study the subpopulation composition of the lymphoid infiltrate in early luminal breast cancer in patients receiving neoadjuvant chemotherapy (NACT) and its effect on achieving a pathological complete response (pCR). Materials and methods. We included 24 patients who received anthracycline-taxane-contain-ing preoperative chemotherapy. The subpopulation composition of TIL was assessed in core-biopsy samples before starting NACT in all patients; after treatment, the assessment was made on postoperative material. The analysis was carried out by flow cytometry. Clinical and immunological assessment was carried out for the following seven subpopulations of lymphocytes: CD3+, CD3+CD4+, CD3+CD8+, CD4+CD127+CD25+, CD3 CD19+ CD3CD16+CD56+, CD3+CD16+CD56+. Results. The incidence pCR was 16.7 %. It was revealed that the initial level before treatment of CD3+, CD3+CD4+, CD3+CD8+, CD4+C-D127+CD25+, CD3-CD19+, CD3 CD16+CD56+, CD3+CD16+CD56+ lymphocytes did not differ depending on the stage of the disease (II or III), tumor subtype (luminal A/B) and Ki-67 level (up to 20, 20-39, 40 and more). No correlations were found between Ki-67 and TIL content. When conducting regression analysis, it was revealed that only the level of CD3+, CD3+CD8+ and CD19+ was a significant factor in achieving a pCR (p = 0.005). When an empirical subgroup was identified, which was characterized by a high content (above or equal to the median) of CD3+, CD3+CD8+ and low (below the median) CD19+ (four observations), the frequency of pCR reached 75 %. Conclusion. Thus, the initial level of T-lymphocytes (CD3+, CD3+CD8+) and B-lymphocytes (CD19+) in the tumor, regardless of the stage of the disease, tumor subtype, ki-67 index, was a predictor of high sensitivity to neoadjuvant chemotherapy of luminal breast cancer and was associated with higher frequency of pCR.