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<p>The assessment of tumor-infiltrating lymphocyte (TILs), together with gene expression signatures (GES), has the potential to guide personalized breast cancer therapy. We included 262 patients from the phase III NSABP B-41 trial, which evaluated neoadjuvant HER2-targeted therapies in combination with chemotherapy. We conducted a manual and artificial intelligence (AI)-based analyses of TILs, as well as GES from RNA sequencing. Higher manual TILs as a continuous variable were associated with pathologic complete response (pCR) in patients with estrogen receptor (ER)-negative disease. AI-based TILs were associated with pCR regardless of ER status. Immune GES (iGES) were associated with pCR. Manual TILs were not associated with event-free survival (EFS), while AI-TIL showed a marginal association. These results support the use of TIL assessment, complemented by GES, as a prognostic biomarker in HER2-positive breast cancer. Future studies are needed to evaluate their predictive utility to guide treatment decisions.</p>

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AI-powered and manual assessment of tumor-infiltrating lymphocytes in early HER2-positive breast cancer in NSABP B-41

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年5月14日

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  • Ilana Schlam,
  • Gong Tang,
  • Khalid AbdulJabbar,
  • Haixi Yan,
  • Xuelin Gu,
  • Tanner J. Freeman,
  • Sai Maley,
  • Brent T. Harris,
  • Priya Rastogi,
  • Isaac Hook,
  • Norman Wolmark,
  • Roberto Salgado,
  • Sandra M. Swain

摘要

The assessment of tumor-infiltrating lymphocyte (TILs), together with gene expression signatures (GES), has the potential to guide personalized breast cancer therapy. We included 262 patients from the phase III NSABP B-41 trial, which evaluated neoadjuvant HER2-targeted therapies in combination with chemotherapy. We conducted a manual and artificial intelligence (AI)-based analyses of TILs, as well as GES from RNA sequencing. Higher manual TILs as a continuous variable were associated with pathologic complete response (pCR) in patients with estrogen receptor (ER)-negative disease. AI-based TILs were associated with pCR regardless of ER status. Immune GES (iGES) were associated with pCR. Manual TILs were not associated with event-free survival (EFS), while AI-TIL showed a marginal association. These results support the use of TIL assessment, complemented by GES, as a prognostic biomarker in HER2-positive breast cancer. Future studies are needed to evaluate their predictive utility to guide treatment decisions.