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Breast cancer prognosis: 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 found that in certain types of breast cancer, immune cells determine the chances of survival. 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 are diagnosed with breast cancer in Germany every year," wrote the German Cancer Aid in a statement. Breast cancer is the most common malignant tumor in women. As a rule, the chances of a cure increase the earlier the tumor is discovered and the more precisely it can be diagnosed. With certain forms of breast cancer, the immune cells also decide on the chances of survival, as German researchers have now found out. These cells also predict the benefits of chemotherapy.
Immune cells determine the chances of survival
If immune cells penetrate the tumor, this is generally considered a good sign because the body's defense against cancer appears to be working.
In certain types of breast cancer, immune cells, so-called tumor-infiltrating lymphocytes (TILs), decide on the chances of survival and also predict the benefits of chemotherapy.
This is shown by the largest meta study to date on the TIL content of scientists from the German Consortium for Translational Cancer Research (DKTK) at the Charité - Universitätsmedizin Berlin in collaboration with the German Breast Group.
The results of the study were recently published in "The Lancet Oncology".
Decision for or against chemotherapy
Choosing or opposing 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 has to be removed.
However, it is also associated with serious side effects, so that doctors have to weigh the benefits and risks for the patients.
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 particularly effective against the tumors.
Sign of good chances of recovery
"Especially with rapidly growing breast tumors, immune cells that can be detected in the tumor are a sign of good chances of recovery, the tumor is then visible to the immune system," explains Carsten Denkert from the Charité Institute of Pathology in a message.
Denkert, who is one of the breast cancer specialists at the DKTK, and his colleagues wanted to know how reliably the TIL content can be used as a biomarker for different types of breast cancer and which immune cell types are the decisive indicators.
The most extensive study to date on the immune cell content in breast cancer has shown that there are serious differences.
The scientists and doctors analyzed the proportion of tumor-infiltrating immune cells in 3,771 tissue samples from patients from six clinical breast cancer studies. All women received chemotherapy before the operation.
The study was able to clearly show that a high TIL level goes hand in hand with better response to therapy and good chances of survival in patients with so-called triple-negative and HER2-positive breast cancer.
"In this situation, chemotherapy and the immune system support each other to fight the tumor," says Denkert.
TIL content with high prognostic value
However, the situation is quite different for the luminal subtype (hormone receptor positive / HER2 negative), as the study showed. Patients with this type of breast cancer showed lower overall TIL values and here the TILs were not associated with improved survival.
"We therefore assume that this type of breast cancer is based on a different immune response and that the composition of the invading immune cells is different," summarizes Denkert.
A closer look revealed that macrophages, which belong to the white blood cells, in the tumor are a sign of a poor prognosis for luminal breast cancer.
In contrast, a high proportion of antibody-producing B cells correlated with good chances of survival.
"Our results show that the TIL content in some aggressive forms of breast cancer has a high prognostic value in order to be able to predict which patients will benefit from chemotherapy," Denkert emphasizes.
In order to further improve the response, immunotherapies are currently being tested which are also intended to activate the immune system against the tumor.
In cooperation with the German Breast Group, biomarker tests are being carried out in the GeparNuevo clinical study at the DKTK location in Berlin to find out to what extent the immune cells are suitable as markers for successful immunotherapy with so-called checkpoint inhibitors.
In the future, TILs will be used as markers to better control breast cancer therapy for patients. (ad)