Tumor-specific major histocompatibility-II expression predicts pathological complete response to atezolizumab combined to chemotherapy in triple-negative breast cancer
Journal
npj Breast Cancer
Series/Report No.
Npj Breast Cancer
Journal Volume
11
Journal Issue
1
ISSN
2374-4677
Date Issued
2025-09-29
Author(s)
Balko, Justin M.
Licata, Luca
Wang, Xiao Qian
Dugo, Matteo
Egle, Daniel
Bermejo, Begoña
Zamagni, Claudio
Thill, Marc
Anton, Antonio
Russo, Stefania
Sevillano, Elena
Ciruelos, Eva Maria
Greil, Richard
Semiglazov, Vladimir
Colleoni, Marco
Kelly, Catherine M.
Mariani, Gabriella
Del Mastro, Lucia
Zambelli, Stefania
Viale, Giulia
Callari, Maurizio
Viale, Giuseppe
Pusztai, Lajos
Gianni, Luca
Ali, H. Raza
Bianchini, Giampaolo
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.
SDGs
Publisher
Springer Science and Business Media LLC
Type
journal article