Tumori Journal Abstract Book - October 2020 - 110

110	

E20
TRIPLE NEGATIVE BREAST CANCER:
TIL'S QUALITATIVE STUDY AND
PROGNOSTIC IMPLICATIONS
Della Mora A.1, Santinelli A.2, Pistelli M.3, Crocetti S.3, Tassone L.3,
Bastianelli L.3, Merloni F.3, Cantini L.3, Scortichini L.3, Agostinelli V.3,
Savini A.3, Maccaroni E.3, Berardi R.3
1

UO Oncologia di Macerata, Area Vasta 3, Macerata; 2AO- Ospedali Riuniti
Marche Nord, Pesaro; 3Clinica Oncologica e Centro Regionale di Genetica
Oncologica, Università Politecnica delle Marche, AOU Ospedali Riuniti,
Ancona

Background: Triple negative breast cancers (TNBC) represent 15-20% of all breast cancer, but determine up today
a high number of death because of their aggressive behaviour, with a high growth rate and the frequent late diagnosis. Due to the lack of target for specific therapies, in the
last years, immune system and its interaction with breast
cancer gained importance, in particular the role of tumoral
immunitary infiltrate (TIL) and its cellular components,
given the advent of immunotherapy.
Material and Methods: In this retrospective study, we
enrolled 148 female patients affected by infiltrating triple
negative breast cancer treated at Azienda OspedalieroUniversitaria Ospedali Riuniti of Ancona from 2003 to
2016. We attested the presence of TIL in E&E stained histological pieces with a cut-off of positivity of 5% and we
searched the possible correlation between TIL, the clinical-pathological features and prognosis (in terms of disease free survival-DFS- and overall survival -OS). Then in
TIL positive pieces we analysed the components of TIL
itself, using immuno-histochemical staining for CD8
(cytotoxic T lymphocytes), CD4 (helper T lymphocytes),
FOXP3 (regulatory T lymphocytes) and CD56 (Natural
Killer cells), in order to assess the possible correlations
between the single components and the clinical-pathological features and the prognosis.
Results: At the chi-square analysis, stromal TIL correlates with high histological grade, ductal histology and
the presence of peritumoral follicles. The TIL has a positive impact on the prognosis (p=0.0001), in particular
when it is more than 50% (p=0.0087) and/or when it is
organized in peritumoral follicles (p=0,0071). Moreover,
tumor size, age, pausal status and lymphovascular invasion are prognostic in terms of DFS and OS. From the
qualitative analysis of TIL emerges that FOXP3 expression in the lymphocytic infiltrate is statistically significant for disease free survival (p=0.0492) and overall
survival (p=0.0390), while there are no association with
other TIL components.
Conclusions: Our study confirm that the immune system
plays a role in regulating tumour growth and can be used
as prognostic parameter, in particular evaluating stromal
TIL and the presence of FOXP3 in the lymphocytic

Tumori Journal 106(2S)
infiltrate. These data have a not negligible importance
given the upcoming insert of immunotherapy in clinical
practice in various setting of treatment of TNBC and are
worthy of further studies.

E21
PROGNOSIS AND RESPONSE TO
NEOADJUVANT CHEMOTHERAPY
ACCORDING TO HER2 EXPRESSION IN
EARLY BREAST CANCER: a retrospective
single institution analysis
D'Onofrio R.1, Omarini C.1, Barbolini M.1, Nasso C.1, Isca C.1,
Dominici M.1, Piacentini F.1
1

University Hospital of Modena, Modena

Background: The assessment of HER2 status plays a key
role in the treatment decision making process of early
breast cancer (BC).HER2 status is routinely assessed by
immunohistochemistry and/or in situ hybridization (ISH),
according to ASCO/CAP 2018 guidelines. The dichotomous definition of HER2+ versus HER2- disease does
not reflect the spectrum of variable levels of HER2 protein expression. We have analyzed the clinical outcomes
of a cohort of BC patients treated with neoadjuvant chemotherapy (NACT) according to HER2 score.
Patients and methods: We performed a retrospective
analysis of 483 women with early BC treated with NACT
from March 2002 to November 2018 at Modena Cancer
Center. Clinical and pathological characteristics of patients
and disease were collected and compared to HER2 score
by Pearson's chi square test. The impact of HER2 status on
pathological complete response (pCR) was set according
to logistic regression model.
Results: According to HER2 score, patients were divided
in 5 groups: 79 (16,3%) of them in HER2 score0 group,
153 (31,7%) in HER2 score1+, 53 (11%) HER2 score2+/
ISH-, 43 (9%) score2+/ISH+ and 155 (32%) score3+. Of
note, 59% of women had hormone receptor positive BC.
Overall, the HER2 status significant correlated to histotype (p=0,003), grading (p=0,026) and pCR (p=0,0001).
The pCR was achieved in 132 (27%) patients: 46 (9,5%) in
HER2 score0/1+ group, 9 (1,9%) in HER2 score2+/ISH-,
8 (1,7%) in HER2 score2+/ISH+ and 69 (14,3%) in
HER2 score3+. The pCR rate was not statistically different when both HER2 score0/1+ and HER2 score2+/ISHgroups were compared to HER2 score2+/ISH+ one.
Considering HER2+ BCs, the pCR rate was significantly
higher in HER2 score3+ compared to HER2 score2+/
ISH+ (p=0,002). No statistically significant differences in
terms of RFS and OS inter-subgroups were observed.
Conclusions: The HER2 protein expression levels better
correlated to pCR compare to HER2 gene amplification. In
particular, the lack of difference in pCR rate between
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