Tumor infiltrating lymphocytes (TILs) as a predictive marker of pathological complete response (pCR) in a diverse patient population with early triple negative breast cancer (TNBC) treated with neoadjuvant real-world KEYNOTE-522 regimen

作者：Riya Albert, Joshua Thomas, Navid Sadeghi, Sangeetha M. Reddy, Glenda Delgado Ramos, Heather McArthur, Samira Syed, Deborah Farr, Nisha Unni · 发表于：Breast Cancer Research and Treatment · 年份：2026 · DOI：10.1007/s10549-026-08002-7 · 被引用次数：1 · 研究领域：Cancer Immunotherapy and Biomarkers、Breast Cancer Treatment Studies、Inflammatory Biomarkers in Disease Prognosis

INTRODUCTION: Triple-negative breast cancer (TNBC) is an aggressive subtype characterized by poor prognosis. Based on the KEYNOTE-522 trial, neoadjuvant pembrolizumab plus chemotherapy has become the standard of care due to significantly improved pathological complete response (pCR) rates. The presence of tumor-infiltrating lymphocytes (TILs) is a predictive biomarker of pCR. This retrospective cohort study examines a diverse patient population treated with the K522 regimen to determine if TILs predict pCR relative to other clinical and tumor-specific factors. METHODS: We retrospectively reviewed 187 patients with early-stage TNBC at two institutions (one tertiary care, one safety-net) who completed neoadjuvant K522 treatment between 2021 and 2024. Statistical analyses included Chi-squared tests, Z-tests, and univariate logistic regression to evaluate associations between TILs, ethnicity, tumor grade, and pCR, and multivariate logistic regression to assess whether the association between dose intensity and pCR differed by the presence of TILs at baseline. RESULTS: The overall pCR rate was 57%; TILs were present in 52.8% of cases. TILs were associated with a significantly higher pCR rate (70% vs. 48% without TILs; p = 0.0027). While pCR rates were similar across ethnicities, Hispanic patients with TILs had significantly higher pCR than those without (80.0% vs. 51.5%; p = 0.0254). Controlling for grade, patients with TILs were 2.442 times more likely to achieve pCR (CI: 1.310-4...