Tumor-Infiltrating Lymphocytes Predicted Outcomes in Triple-Negative Breast Cancer

Editor’s note: It can be useful for oncologists to be able to predict how well a particular treatment might work for a particular cancer patient. This article describes new research that points to a potential new way of predicting whether people with triple-negative breast cancer might benefit from chemotherapy after tumor-removal surgery to prevent the cancer from returning (“adjuvant chemotherapy”). The scientists found that measuring stromal lymphocytic infiltration — the amount of certain immune system cells found in so-called “stromal” cells adjacent to the tumor — could potentially be used to predict the outcome of adjuvant chemotherapy. Specifically, the greater the degree of stromal lymphocytic infiltration, the lower the risk of recurrence or death.

“Stromal lymphocytic infiltration significantly and independently predicted outcomes in patients with triple-negative breast cancer treated with adjuvant chemotherapy, according to an analysis of data from two randomized phase 3 trials.

“Sylvia Adams, MD, assistant professor of medicine at New York University Cancer Institute, and colleagues evaluated 506 tumors for density of tumor-infiltrating lymphocytes (TILs) in intraepithelial and stromal compartments. The tumors were randomly selected from the ECOG E2197 and E1199 trials based on availability of sections…

“Median follow-up was 10.6 years. Researchers found that higher stromal TILs scores were associated with a better overall prognosis. Specifically, every 10% increase in stromal TILs correlated with a 19% decreased risk for death (P=.01), an 18% decreased risk for distant recurrence (P=.04), and a 14% decreased risk for recurrence or death (P=.02).”

Outcome of Triple Negative Breast Cancer: Comparison of Sporadic and BRCA1-Associated Cancers

“The authors compare the clinical outcome and sites of relapse of TNBC in BRCA1 mutation carriers and non–carriers who received adjuvant chemotherapy. Results suggest that BRCA1 mutation carriers with TNBC had similar survival rates and sites of recurrence to non–carriers after treatment with conventional chemotherapy.”

Editor’s note: This article describes a breast cancer study that compared patients with BRCA1 mutations to patients without BRCA1 mutations. It was found that, after conventional chemotherapy, BRCA1-positive patients with triple-negative breast cancer had similar survival rates and sites of recurrence to BRCA1-negative patients.

Some Aggressive Cancers May Respond to Anti-Inflammatory Drugs

“New research raises the prospect that some cancer patients with aggressive tumors may benefit from a class of anti-inflammatory drugs used to treat rheumatoid arthritis.

“Studying triple-negative breast cancer, researchers at Washington University School of Medicine in St. Louis found that some aggressive tumors rely on an antiviral pathway that appears to drive inflammation, widely recognized for roles in cancer, rheumatoid arthritis and other inflammatory diseases.

“The tumors that activate this particular antiviral pathway always have dysfunctional forms of the proteins p53 and ARF, both encoded by genes known for being highly mutated in various cancers. The investigators found that the two genes compensate for each other. If both are mutated, the tumors that form are more aggressive than if only one of these genes is lost.

“When both genes are lost and the antiviral pathway is activated, patients may benefit from a class of anti-inflammatory drugs called JAK inhibitors, currently prescribed for rheumatoid arthritis.”

Editor’s note: Recent research shows that drugs known as JAK inhibitors, often prescribed for arthritis, might also help fight certain types of breast cancer. Specifically, JAK inhibitors might benefit patients with triple-negative breast cancer whose tumors have mutated forms of the proteins p53 and ARF. The researchers are working with specialists to identify patients with those mutations who might benefit from JAK inhibitors.

Basilea Announces Start of Phase 2a Study with Oncology Drug Candidate BAL101553

“Basilea Pharmaceutica Ltd. (SIX: BSLN) reports today that it initiated a phase 2a study with its investigational oncology drug BAL101553. The study is designed to further characterize safety and tolerability, and to obtain efficacy data in adult patients with advanced or recurrent solid tumors who have failed standard therapy or for whom no effective standard therapy is available. Tumor types were selected based on clinical observations in the phase 1 study and a detailed analysis of potential patient stratification biomarkers across tumor indications. The study will also continue the extensive biomarker testing initiated in Phase 1, to further evaluate dose and patient populations most likely to respond.”

Editor’s note: A drug company is starting a clinical trial to test a new cancer drug called BAL101553 in volunteer patients. The trial is enrolling people with advanced or recurrent solid tumors, including people with colorectal cancer, gastric cancer or cancers of the gastro-esophageal junction, non-small cell lung cancer (NSCLC), ovarian cancer (or primary peritoneal), pancreatic cancer (including ampullary), and triple-negative breast cancer. Specifically, the trial is open to patients who have tried a standard treatment without benefitting or who, for whatever reason, have no effective standard treatment available to them. BAL101553 has already shown promise for some patients in a phase I trial. The new trial will continue to examine the safety and effectiveness of the drug, and it will also test patients’ tumors for specific biomarker molecules to see if patients with certain biomarkers are more likely to benefit.