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Low levels of intra-tumoural T cells in breast cancer identify clinically frail patients with shorter disease-specific survival.

Abstract：

OBJECTIVES:The global health status of older patients with cancer influences their clinical course, but little is known regarding the influence of the immune system on the global health of older patients with cancer. The goal of this study was to assess the relationships between patient fitness/frailty status and survival, and the local tumour immune environment of older patients with breast cancer. MATERIALS AND METHODS:In a cohort of 58 older patients with breast cancer (over 70 years of age), fluorescence microscopy was used to investigate whether levels of intra-tumoural T cells (CD3+) and granulocytic cells (CD15+) could predict clinical outcome, and/or whether they correlated with patient physical and mental performance as evaluated by comprehensive geriatric assessment. RESULTS:We observed that patients with higher levels of intra-tumoural T cells were fitter according to a number of clinical health measures including G8 (p = 0.006), Karnofsky Index (p = 0.0372), and Leuven Oncology Frailty Score (LOFS) (p = 0.0187). In contrast, high relative levels of granulocytic cells were found in patients with poorer clinical health (LOFS, p = 0.0474). Furthermore, high levels of T cells but not granulocytic cells were associated with longer breast cancer-specific survival (p = 0.0444). CONCLUSIONS:This is the first study to show that low relative levels of intra-tumoural T cells are associated with inferior patient fitness. In contrast to T cells, we observed that intra-tumoural granulocytic cells displayed an inverse relationship with patient performance. Further research is needed to determine whether boosting the level of intra-tumoural T cells in older non-fit patients can result in improved outcome.

journal_name

J Geriatr Oncol

journal_title

Journal of geriatric oncology

authors

Speigl L,Grieb A,Janssen N,Hatse S,Brouwers B,Smeets A,Floris G,Bailur JK,Kenis C,Neven P,Wildiers H,Pawelec G,Shipp C

doi

10.1016/j.jgo.2018.03.021

subject

Has Abstract

pub_date

2018-11-01 00:00:00

pages

606-612

issue

eissn

1879-4068

issn

1879-4076

pii

S1879-4068(18)30135-8

journal_volume

pub_type

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Low levels of intra-tumoural T cells in breast cancer identify clinically frail patients with shorter disease-specific survival.