Emerging Soluble Immune- Related Biomarkers in Early Triple Negative Breast Cancer - Abstract
Background: Triple Negative Breast Cancer (TNBC) is a heterogeneous disease representing about 15% of all Breast Cancers (BC). TNBC are usually high-grade histological tumors, characterized by their aggressiveness and difficulty of treatment due to the lack of available targeted therapies. There is a strong association between achieving Pathological Complete Response (pCR) after neoadjuvant treatment and higher rates of Disease-Free Survival (DFS) and Overall Survival (OS).
Objectives: This prospective, observational, descriptive and analytical study attempts to identify new soluble immune biomarkers in early TNBC patients who received Neoadjuvant Chemotherapy (NCT) before surgery. Baseline histopathological and plasma biomarkers were analyzed and correlated with clinical features to assess their predictive and prognostic value.
Results: The expressions of Ki-67, EGFR, HER2 low and androgen receptors did not prove to have a predictive or prognostic value in early TNBC. An increase in the percentage of tumor-infiltrating lymphocytes (TILs) was correlated with better DFS (p-value 0.0047) and OS (p-value 0.031). Elevated plasma levels of certain cytokines and immune checkpoints like sGal-3 (p-value 0.03) and sGM-CSF (p-value 0.02), and lower levels of sCD86 (p-value 0.02) and sITAC (p-value 0.02), predicted poorer NCT response. Increased levels of sGal-3 (p-value 0.049), sMIP-3? (p-value 0.005), sIL-10 (p-value 0.002), sIL-13 (p-value 0.009), sIL-17A (p-value 0.049), and sTIM-3 (p-value 0.0049) were significantly associated with worse survival outcomes.
Conclusion: In early TNBC, diverse plasma cytokines and immune checkpoints were associated with a worse response to NCT and poor survival. The implementation of liquid biopsy analysis for the determination of soluble biomarkers could help for treatment planning and future therapeutic strategies.