Tumor-infiltrating Lymphocyte Score Based on FDG PET/CT for Predicting the Effect of Neoadjuvant Chemotherapy in Breast Cancer

Anticancer Res. 2020 Jun;40(6):3395-3400. doi: 10.21873/anticanres.14323.

Abstract

Aim: To investigate whether tumor-infiltrating lymphocyte (TIL) scoring based on 18F-fluorodeoxyglucose positron-emission tomography/computed tomography (FDG PET/CT) can predict the pathological response to neoadjuvant chemotherapy.

Patients and methods: A total of 261 patients with breast cancer underwent complete resection after neoadjuvant chemotherapy. PET-TIL score was calculated using tumor size, Ki-67 labeling index, and maximum standardized uptake value (SUVmax) on FDG PET/CT. The efficacy of the PET-TIL score in predicting the pathological complete response (pCR) was retrospectively evaluated.

Results: pCR rates were 11.4%, 58.6%, and 38.8% in luminal, human epidermal growth factor receptor 2 (HER2)-positive, and triple-negative breast cancer, respectively. The corresponding median PET-TIL scores were 28, 37, and 45. pCR rates were 20.0% and 44.2% in the low and high PET-TIL score groups, respectively (p<0.001). HER2-positive and triple-negative subtypes and high PET-TIL score were independent predictors for pCR.

Conclusion: PET-TIL score can predict pCR after neoadjuvant chemotherapy in breast cancer.

Keywords: Breast cancer; PET; SUV; neoadjuvant chemotherapy; pathological complete response; tumor-infiltrating lymphocyte.

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Biomarkers, Tumor
  • Breast Neoplasms / diagnostic imaging*
  • Breast Neoplasms / drug therapy
  • Breast Neoplasms / mortality
  • Breast Neoplasms / pathology*
  • Female
  • Fluorodeoxyglucose F18*
  • Humans
  • Lymphocytes, Tumor-Infiltrating / metabolism
  • Lymphocytes, Tumor-Infiltrating / pathology*
  • Middle Aged
  • Neoadjuvant Therapy
  • Neoplasm Grading
  • Neoplasm Staging
  • Positron Emission Tomography Computed Tomography* / methods
  • Prognosis
  • ROC Curve
  • Treatment Outcome
  • Tumor Microenvironment
  • Young Adult

Substances

  • Biomarkers, Tumor
  • Fluorodeoxyglucose F18