COMMENTARY

Innate Immune Response Produces 'Phenomenal' Breast Cancer Control

Kathy D. Miller, MD

Disclosures

October 01, 2020

This transcript has been edited for clarity.

Hi. It's Dr Kathy Miller with Indiana University. There is another really important study from the science weekend at ESMO that I want to make sure you see because I fear it might be overlooked.

It's the PARADIGM analysis. This was a correlative analysis, not an individual clinical trial. The authors were interested in looking at the potential impact of our innate immune response, our body's ability to recognize a triple-negative tumor and potentially to control it on outcome.

To avoid the potential confounders of the effects of our treatment, the investigators looked at women who did not receive systemic therapy. This is a really unique cohort. All of these women were younger than age 40, had triple-negative or low ER–expressing tumors (ER and PR less than 10%), 50% of them were T1Cs (tumors between 1 and 2 cm), and all were lymph node–negative.

Overall, tumors from 481 patients were evaluated for the impact of tumor-infiltrating lymphocytes. Those who had the highest degree of infiltration — the 75th cohort or the highest quartile of patients — had a 93% overall survival at 15 years.

That's phenomenal and clearly shows the power of the immune system when it's able to recognize the tumor.

Also, it gives us the potential to think about how we could identify patients with triple-negative disease, which is the type of disease that strikes fear in our hearts. How could we identify a group of patients who might need less therapy and maybe don't need chemotherapy at all?

This is not something for you to put into practice on Monday morning, but it sure does make you think, and it gives us a way to think about designing clinical trials in the future.

Kathy D. Miller, MD, is associate director of clinical research and co-director of the breast cancer program at the Melvin and Bren Simon Cancer Center at Indiana University. Her career has combined both laboratory and clinical research in breast cancer.

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