sTILs Warrant Research as Response Biomarker in Metastatic Breast Cancer


Daniel G. Stover, MD, suggests that stromal tumor infiltrating lymphocytes may serve as a biomarker of immune activation and can potentially help optimize therapy with microtubule-targeting agents for patients with metastatic breast cancer.

At the 2023 American Society of Clinical Oncology (ASCO) Annual Meeting, Daniel G. Stover, MD, spoke with CancerNetwork® about findings from the phase 3 CALGB 40502 (Alliance) trial (NCT00785291). In particular, he discussed how immune activation measured by stromal tumor infiltrating lymphocytes (TILs) may correlate with responses to microtubule-targeting agents among patients with metastatic breast cancer.1

Stover, associate professor of medicine and director of Translational Breast Cancer Research at The Ohio State University Comprehensive Cancer Center, stated that results from the AURORA study may also suggest a relationship between stromal TILs and patient outcomes in the metastatic setting, especially in those with triple-negative breast cancer (TNBC).2 However, he emphasized that additional trials are necessary for validating this association in other settings.


We performed multivariable analyses with additional factors and stromal TILs continued [to] trend towards association with outcomes. But there are multiple factors that influence a patient's response to these targeted therapies. Stromal TILs as a marker of immune activation should be one biomarker that could be incorporated as we think about optimizing therapy for patients. The [benefit] of stromal TILs is that it's such an accessible biomarker easily enumerated off routine slides.

This study certainly warrants further validation among additional samples in the metastatic setting. As we saw from the AURORA study presented in the same session, there is evidence that stromal TILs may have an association with outcomes in the metastatic setting, particularly among [TNBCs]. But the next step, beyond validating this in additional settings or situations, is to design those trials that can impact therapy decisions based on the stromal TIL number.


  1. Stover DG, Salgado R, Savenkov O, et al. Association of tumor infiltrating lymphocyte quantity with survival in patients (pts) with metastatic breast cancer (MBC) receiving microtubule-targeting agents: post hoc analysis CALGB 40502 (Alliance). J Clin Oncol. 2023;41(suppl 16):1010. doi:10.1200/JCO.2023.41.16_suppl.1010
  2. Hilbers F, Venet D, Agostinetto E, et al. Characterization of the immune microenvironment in matched primary and metastatic breast cancer lesions from the AURORA study: BIG 14-01. J Clin Oncol. 2023;41(suppl 16):1009. doi:10.1200/JCO.2023.41.16_suppl.1009
Related Videos
Additional analyses of patient-reported outcomes and MRD status in the QuANTUM-First trial are also ongoing, says Harry P. Erba, MD, PhD.
Overall survival data with blinatumomab in the phase 3 E1910 study may be an “important development” in CD19-positive B-ALL.
Intraoperative radiation therapy may allow surgical and radiation oncologists to collaboratively visualize at-risk areas in patients with cancer.
Positive margin rates have not appeared to improve for patients with cancer undergoing surgical care based on several prior studies.
Investigators must continue to explore the space for lisocabtagene maraleucel in mantle cell lymphoma, according to Manali Kamdar, MD.
Those with CML should discuss adverse effects such as nausea or fatigue with their providers to help optimize their quality of life during treatment.
Patients with CML can become an active part of their treatment plan by discussing any questions that come to mind with their providers.
Jorge E. Cortes, MD, emphasizes proper communication between patients with chronic myeloid leukemia and their providers during the treatment course.
Dietary interventions or other medications may help mitigate diarrhea in patients who undergo therapy for chronic myeloid leukemia.
Considering notable adverse effects associated with treatment may be critical when selecting therapy options for those with CML.
Related Content