Dados do Trabalho

Título

PREVALENCE OF PD-L1 AMONG PATIENTS WITH METASTATIC TRIPLE NEGATIVE METASTATIC BREAST CANCER (MTNBC) AND ITS ASSOCIATION WITH TUMOR INFILTRATING LYMPHOCYTES (TIL)

Apresentação do caso

Immune checkpoint inhibitors (ICIs) combined with chemotherapy have emerged as the first line for patients with mTNBC whose tumors are PD-L1 positive. However, given the paucity of data in Brazilian populations, the objective of this study is to evaluate prevalence of PD-L1 positive mTNBC in a single Brazilian center and its association with TIL.

Discussão

Among the 46 female patients tested for PD-L1 in our institution, 25 (54,4%) presented with mTNBC. Among this group (median age 46 years), the majority was diagnosed between 2016 and 2020 (56%), in stages I or II (56%) and had invasive ductal carcinomas (96%). Most patients (23; 92%) underwent the SP-142 Ventana test, and the prevalence of positive (PD-L1 ≥ 1%) patients was 40% . Samples from primary tumor were more likely to be PD-L1 positive (9/17; 53%) compared with samples from metastatic sites (1/8; 12,5%) tumors. A total of 19 had TIL assessment. Most cases presented with low TIL (n=14; 73,7%), followed by intermediate TIL (n=5; 26,3%) and no cases of high TIL. Patients with PD-L1 negative tumors were more likely to present tumors with low TIL (9/11; 81,8%) versus those with PD-L1 positive tumors (5/8; 62,5%). A total of 13 patients received ICI plus chemotherapy. For this subset of patients, the median age was 47, 69,3% (n=9) had PD-L1 positive tumors, and most of them (n=12) received atezolizumab plus nab-paclitaxel. Only 1 patient received ICI as first line.
The median PFS was 2,36 months (2,4 months for PD-L1+ and 2,01 months PD-L1-). Two patients received the combination of ICI plus chemotherapy > 6 months. Disease progression was the main reason (64%) for ICI interruption. Only one patient stopped therapy for toxicity (neuropathy).

Comentários finais

To our knowledge, this is the first “real -world” Brazilian study evaluating the prevalence of PD-L1 positive mTNBC and its association with TIL. The prevalence of PD-L1 in mTNBC is consistent with scientific literature and physicians should prioritize performing the test in samples from primary tumors

Palavras-chave

triple negative breast cancer; immunotherapy; PD-L1; TIL