Tumor-specific major histocompatibility-II expression predicts pathological complete response to atezolizumab combined to chemotherapy in triple-negative breast cancer.
- Abstract:
- Adding immune checkpoint inhibitors to neoadjuvant chemotherapy improves outcomes in early-stage triple-negative breast cancer (TNBC), but a fraction of patients derive benefit. Tumor-specific MHC-II (tsMHC-II) expression has been shown to be a predictive biomarker of pathological complete response (pCR) to neoadjuvant chemo-immunotherapy in early-stage TNBC. We performed biomarker analysis of the phase III NeoTRIP trial where patients were randomized to neoadjuvant carboplatin and nab-paclitaxel±atezolizumab. Imaging mass cytometry was used to assess tsMHC-II expression in tumor samples. TsMHC-II positivity was predefined as ≥5% of tumor cells expressing MHC-II, and at an 80th percentile exploratory cutoff. TsMHC-II positivity was associated with a higher pCR rate in the atezolizumab arm (OR:2.58; P = 0.016), but not in the chemotherapy-only arm (OR:1.37; P = 0.34) and these results were stronger using the exploratory cutoff. TsMHC-II expression is associated with improved response to neoadjuvant chemo-immunotherapy in early TNBC and could represent a clinically useful predictive biomarker for treatment personalization.
- Authors:
- JM Balko, L Licata, XQ Wang, M Dugo, C-S Huang, D Egle, B Bermejo, C Zamagni, M Thill, A Anton, S Russo, E Sevillano, EM Ciruelos, R Greil, V Semiglazov, M Colleoni, CM Kelly, G Mariani, L Del Mastro, S Zambelli, G Viale, M Callari, G Viale, L Pusztai, L Gianni, HR Ali, G Bianchini
- Journal:
- NPJ Breast Cancer
- Citation info:
- 11(1):103
- Publication date:
- 29th Sep 2025
- Full text
- DOI