The latest LOBULAR news from SABCS 2015

JohnSmith
JohnSmith Member Posts: 651
edited December 2015 in ILC (Invasive Lobular Carcinoma)

The 38th annual San Antonio Breast Cancer Symposium (SABCS) starts December 8. This is the most important conference of the year.
The SABCS website has been updated with the Program, Poster Sessions, Abstracts, etc.

I carefully reviewed the titles of the 1,200 papers accepted. 10 are focused on ILC. Oh my!
PILC, LCIS, PLCIS added another 5. In total, 15 with the term "Lobular" in the title.
Obviously a testament to the understudied nature of Lobular research.

Below are those 15 titles, followed by more details.

  • "Lymphocytic infiltration in invasive Lobular breast cancer"
  • "LCIS displays intra-lesion genetic heterogeneity and its progression to invasive disease involves clonal selection and variations in mutational processes"
  • "Pleomorphic lobular carcinoma in situ (PLCIS) - presentation, associated lesions and outcome"
  • "Time trends in incidence rates and survival for women with de novo metastatic Lobular vs. Ductal carcinoma, a population-based study"
  • "Therapeutic mammoplasty reduces high incomplete excision rate in Lobular cancer"
  • "Invasive Lobular carcinoma cell lines utilize WNT4 signaling to mediate estrogen-induced growth"
  • "A neoadjuvant window trial of endocrine response in women with invasive Lobular carcinoma". Clinical Trial link is HERE.
  • "Only in Lobular breast cancer MRI use is associated with a lower risk of positive surgical margins and a reduced number of mastectomies. A real-world analysis in The Netherlands"
  • "miR-135a is associated with a metastatic phenotype in invasive Lobular carcinoma"
  • "Correlation of apparent diffusion coefficient with Standardized Uptake Value in invasive Lobular carcinoma of breast using in hybrid 18F-FDG PET/MR"
  • "Trends in incidence, patient characteristics, and management of LCIS"
  • "Expression of genes for Aromatase Inhibitor targets to discriminate invasive Lobular from invasive Ductal carcinomas of the breast using LCM-procured cells to complement endocrine biomarkers"
  • "Clinicopathological and molecular characteristics of pleomorphic invasive Lobular carcinoma of breast"
  • "Germline CDH1 mutations in LCIS"
  • "Potential role of prolactin signaling in development and growth of the Lobular subtype of breast cancer"

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Wednesday, December 9, 2015 - General Session 1 - Hall D, 9:00am
Link: http://www.sabcs.org/Program/Daily-Schedule/Day-2-Wednesday-12-9-2015

S1-02
General Session - Title: "Lymphocytic infiltration in invasive Lobular breast cancer" Abstract link here.
Desmedt Christine, Salgado R, Buisseret L, Zoppoli G, Fornili M, Van den Eynden G, Garaud S, Gundem G, Rothé F, Brown D, Kheddoumi N, Rouas G, Galant C, Bertucci F, Piccart M, Campbell P, Viale G, Larsimont D, Willard-Gallo K, Biganzoli E, Pruneri G, Sotiriou C.
Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; University of Genoa, Genoa, Italy; University of Milan and Istituto Nazionale Tumori, Milan, Italy; Universiteit Antwerpen, Antwerp, Belgium; Cancer Genome Project, Wellcome Trust Sanger Institute, Hinxton, United Kingdom; Université Catholique de Louvain, Brussels, Belgium; Institut Paoli-Calmettes, Marseille, France; European Institute of Oncology, Milan, Italy.

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Thursday, December 10, 2015 - General Session 4 - Hall D, 4:00pm
Link: http://www.sabcs.org/Program/Daily-Schedule/Day-3-Thursday-12-10-2015

S4-04
General Session - Title: "Lobular carcinoma in situ displays intra-lesion genetic heterogeneity and its progression to invasive disease involves clonal selection and variations in mutational processes" Abstract link here.
Reis-Filho J, Schizas M, Piscuoglio S, Sakr R, Ng C, Lim R, Carniello JV, Towers R, Martelotto L, Giri D, de Andrade V, Viale A, Solit D, Weigelt B, King T.
Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY; Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY and Center for Molecular Oncology, Memorial Sloan Kettering Cancer Center, New York, NY.

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Poster Session 1
Category: Detection/Diagnosis: Diagnostic Pathology
Link: http://www.sabcs.org/Program/Poster-Sessions/Poster-Session-1

P1-01-10
Title: "Pleomorphic Lobular carcinoma in situ (PLCIS)-presentation, associated lesions and outcome" Abstract link here.
Shaaban A, Smith S, Bradley S, McMahon M, Sharma N.
Queen Elizabeth Hospital Birmingham, Birmingham, United Kingdom; St James's University Hospital, Leeds, United Kingdom.

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Poster Session 1
Category: Epidemiology, Risk, and Prevention: Epidemiology - Population Studies
Link: http://www.sabcs.org/Program/Poster-Sessions/Poster-Session-1

P1-07-08
Title: "Time trends in incidence rates and survival for women with de novo metastatic Lobular vs. Ductal carcinoma, a population-based study" Abstract link here.
Di Meglio A, Freedman R, Lin N, Barry W, Metzger-Filho O, Keating N, Winer E, Vaz-Luis I. Dana Farber Cancer Institute, Boston, MA;
IRCCS San Martino University Hospital - IST National Cancer Research Institute, Genova, Italy; Harvard Medical School, Boston, MA; Brigham and Women's Hospital, Boston, MA.

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Poster Session 2
Category: Treatment: Surgery
Link: http://www.sabcs.org/Program/Poster-Sessions/Poster-Session-2

P2-12-14
Title: "Therapeutic mammoplasty reduces high incomplete excision rate in Lobular cancer"
Abstract link here.
Romics L, Kabir S, Mansell J, Mallon E, Stallard S, Doughty J.
Victoria Infirmary Glasgow, Glasgow, United Kingdom; Royal Infirmary Glasgow, Glasgow, United Kingdom; New Southern University Hospital Glasgow, Glasgow, United Kingdom; Western Infirmary Glasgow, Glasgow, United Kingdom.

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Poster Session 3
Category: Tumor Cell and Molecular Biology: Hormonal Factors and Receptors
Link: http://www.sabcs.org/Program/Poster-Sessions/Poster-Session-3

P3-04-02
Title: "Invasive Lobular carcinoma cell lines utilize WNT4 signaling to mediate estrogen-induced growth" Abstract link here.
Sikora M, Oesterreich S.
University of Pittsburgh Cancer Institute, Pittsburgh, PA.

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Poster Session 3
Category: Tumor Cell and Molecular Biology: Endocrine Therapy and Resistance
Link: http://www.sabcs.org/Program/Poster-Sessions/Poster-Session-3

P3-05-14
Title: "A neoadjuvant window trial of endocrine response in women with invasive Lobular carcinoma" Abstract link here.
Jankowitz R, McAuliffe P, Sikora M, Butler L, Ahrendt G, Johnson R, Diego E, Bonaventura M, Puhalla S, Lembersky B, Clark B, Brufsky A, Kurland B, Davidson N, Dabbs D, Oesterreich S.
University of Pittsburgh Cancer Institute, Pittsburgh, PA; UPMC Magee Womens Hospital, Pittsburgh, PA; Magee Womens Research Institute, Pittsburgh, PA.
** Note: The link to this Clinical Trial is HERE.

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Poster Session 4
Category: Detection/Diagnosis: Breast Imaging - MRI
Link: http://www.sabcs.org/Program/Poster-Sessions/Poster-Session-4

P4-02-01
Title: "Only in Lobular breast cancer MRI use is associated with a lower risk of positive surgical margins and a reduced number of mastectomies. A real-world analysis in The Netherlands" Abstract link here.
Tjan-Heijnen V, Lobbes M, Vriens I, van Bommel A, Nieuwenhuijzen G, Smidt M, Boersma L, van Dalen T, Smorenburg C, Siesling S, Voogd A.
Maastricht University Medical Centre, Netherlands; Leiden University Medical Centre, Netherlands; Catharina Hospital, Netherlands; Maastro Clinic, Netherlands; Diakonessenhuis, Netherlands; Netherlands Cancer Institute, Netherlands; Netherlands Comprehensive Cancer Organisation, Netherlands.

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Poster Session 4
Category: Tumor Cell and Molecular Biology: Biomarkers
Link: http://www.sabcs.org/Program/Poster-Sessions/Poster-Session-4

P4-09-08
Title: "miR-135a is associated with a metastatic phenotype in invasive Lobular carcinoma"
Howe, Zhao H, Daneshmand M, Clemons M, Robertson S, Arnaout A, Addison. [miR135a - Addison Lab: http://www.ohri.ca/profile/caddison 1. Dr. Christina Addison, 2. Grant Howe, Post Doc]
Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; The Ottawa Hospital, Ottawa, Ontario, Canada; University of Ottawa, Ottawa, Ontario, Canada.

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Poster Session 5
Category: Detection/Diagnosis: Molecular, Functional, and Novel Imaging
Link: http://www.sabcs.org/Program/Poster-Sessions/Poster-Session-5

P5-01-10
Title: "Correlation of apparent diffusion coefficient with Standardized Uptake Value in invasive Lobular carcinoma of breast using in hybrid 18F-FDG PET/MR" Abstract link here.
Choi JE, Kang SH, Lee SJ, Kong EJ.
Department of Surgery, Yeungnam University College of Medicine, Daegu, Korea; Department of Neuclear Medicine, Daegu, Korea.

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Poster Session 5
Category: Treatment: DCIS/LCIS
Link: http://www.sabcs.org/Program/Poster-Sessions/Poster-Session-5

P5-17-11
Title: "Trends in incidence, patient characteristics, and management of Lobular carcinoma in situ"
Abstract link here.
Johnson A, Guo X, Nygaard R, Zera R.
Hennepin County Medical Center, Minneapolis, MN.

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Poster Session 6
Category: Tumor Cell and Molecular Biology: Genomics
Link: http://www.sabcs.org/Program/Poster-Sessions/Poster-Session-6

P6-03-14
Title: "Expression of genes for aromatase inhibitor targets to discriminate invasive Lobular from invasive Ductal carcinomas of the breast using LCM-procured cells to complement endocrine biomarkers" Abstract link here.
Sanders MA, Daniels M, Wittliff J.
University of Louisville, Louisville, KY.

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Poster Session 6
Category: Tumor Cell and Molecular Biology: Molecular Profiles
Link: http://www.sabcs.org/Program/Poster-Sessions/Poster-Session-6

P6-04-10
Title: "Clinicopathological and molecular characteristics of pleomorphic invasive Lobular carcinoma of breast" Abstract link here.
Segar J, Baker A, MacKerricher W, Nagle R, Livingston R, Clarke K, Ley M, Viscusi R, Gonzalez V, LeBeau L, Chalasani P.
Department of Medicine, University of Arizona, Tucson, AZ; University of Arizona Cancer Center, Tucson, AZ; Department of Pathology, University of Arizona, Tucson, AZ; Department of Surgery, University of Arizona, Tucson, AZ; Department of Radiation Oncology, University of Arizona, Tucson, AZ.

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Poster Session 6
Category: Tumor Cell and Molecular Biology: Genetics - Germline Changes
Link: http://www.sabcs.org/Program/Poster-Sessions/Poster-Session-6

P6-06-02
Title: "Germline CDH1 mutations in Lobular carcinoma in situ" Abstract link here.
Reyes S, Sakr R, Schizas M, Towers R, Park A, Ng C, Weigelt B, Reis-Filho J, King T.
Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY; Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY.

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Poster Discussion 2
Category: Endocrine Therapies
Link: http://www.sabcs.org/Program/Poster-Discussions/Poster-Discussion-2

PD2-08
Title: "Potential role of Prolactin signaling in development and growth of the Lobular subtype of breast cancer"
Katz TA, Logan G, Levine K, Nagle A, Huo Z, Tseng GC, Rui H, Lee AV, Butler LM, Oesterreich S.
University of Pittsburgh Cancer Institute, Pittsburgh, PA; University of Pittsburgh, Pittsburgh, PA; Kimmel Cancer Center, Philadelphia, PA.
Abstract (here): ILC is the eighth most frequently diagnosed cancer in any organ, and accounts for 8-11% of breast cancer. This histological subtype is characterized by loss of E-cadherin, and favorable prognostic factors, such as low Ki67 and high rates of ER/PR-positive tumors. Only recently is the lobular subtype gaining recognition as a distinct disease, displaying a unique growth pattern, unique molecular changes in addition to loss of E-cadherin, and evidence for late recurrences and reduced response to targeted endocrine therapy. It is widely accepted that a late age at first full term birth (FFTB) increases a women's risk for breast cancer. Interestingly, several published epidemiological studies have shown that the increased risk after a late age at FFTB is preferential for the lobular subtype of breast cancer compared to the ductal subtype. We therefore hypothesized that pregnancy hormones like prolactin play an integral role in the development and progression of ILC. Interrogation of the Cancer Genome Atlas (TCGA) data revealed a high expression of milk protein genes as well as prolactin signaling molecules, specifically Stat5a and Stat5b in lobular carcinomas compared to ductal carcinomas. We developed a lactation score including 7 milk protein genes and found that in the TCGA data set ILC tumors have a significantly higher lactation score than IDC tumors. Additionally, we found that ILC cell lines express increased prolactin receptor mRNA and protein levels compared to IDC cell lines. Prolactin treatment in ILC and IDC cells reveals divergent signaling pathways - prolactin stimulates ERK activation in IDC but not ILC cells. We are currently further delineating the prolactin signaling pathways, and resulting phenotypes, comparing ILC and IDC cells. We expect these experiments to move the field forward by establishing a relationship between prolactin and lobular carcinoma.

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Comments

  • Girl53
    Girl53 Member Posts: 225
    edited October 2015

    JohnSmith: You are awesome! Thank you so much. Am particularly interested in LCIS session and speakers for this. Will keep ears open. Thanks again for all you do on this board.

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  • BarredOwl
    BarredOwl Member Posts: 2,433
    edited October 2015

    Hi John:

    That was a huge amount of work! Thanks for assembling and organizing the information.

    BarredOwl

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  • ShetlandPony
    ShetlandPony Member Posts: 4,924
    edited October 2015

    Thanks, JohnSmith. You just saved a tired woman a lot of work.

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  • Lily55
    Lily55 Member Posts: 3,534
    edited October 2015

    THank you John......

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  • wallycat
    wallycat Member Posts: 3,227
    edited October 2015

    In case you don't hear it enough, we LOVE YOU, John!!!

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  • 614
    614 Member Posts: 851
    edited October 2015


    Dear John:

    You are amazing. Thank you so much for all of your research and the time that you spend giving us valuable information.

    614

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  • MmeJ
    MmeJ Member Posts: 167
    edited October 2015

    Thanks, John.

    Yes, once again, the dearth of research on ILC makes itself evident. It isn't clear to me from looking at the schedule if there are any talks specifically on lobular or if all of the attention it is getting is just in poster sessions - which is to say, not much.

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  • JohnSmith
    JohnSmith Member Posts: 651
    edited October 2015

    Compiling this SABCS conference info was easy... a simple "copy and paste".
    The tough part will be dissecting the data, comprehending its relevance and more importantly, determining if ANY of it leads to improved treatment.
    Naturally, there will be Lobular discussions that occur within other topics that aren't titled with "Lobular". Parsing out that info, if published, takes some google skills.
    I might suggest printing out these topics (copy and paste to a word doc) and bringing to your next oncology appointment. Ask your MO which of these, if any, they plan on attending. Put them on the spot, nicely of course. :)
    Remember, you're special... unique. Statistically, out of 10 patients, you're the only Lobular one.
    Be your own advocate.

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  • Optimist52
    Optimist52 Member Posts: 302
    edited October 2015

    Thanks John, that's a kind thought. My MO told me my cancer was very unusual (pleomorphic lobular) so there is very little info out there on how it responds to various chemo regimens. There's a scientific study of ILC happening now at Otago University in New Zealand (where I live). I hope it will add to the knowledge of ILC and benefit us.

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  • JohnSmith
    JohnSmith Member Posts: 651
    edited October 2015

    The following is not SABCS related, but deals with a different breast cancer conference starting today and it includes new Lobular data.
    This weekend is the 8th AACR Conference on "Advances in Breast Cancer Research" in Seattle, Washington.
    It's held every two years and geared towards the research community, rather than conferences like SABCS which have a more clinical agenda.
    This four day conference includes topics on genomics, circulating tumor DNA (ctDNA), epigenomics, animal models, stem cells, metastasis, tumor dormancy, tumor microenvironment and immunity, resistance to targeted therapies, etc.

    ~127 abstracts will be presented. 3 are focused on Lobular.
    Below are those Lobular Abstracts, which include analysis from the European RATHER consortium,
    who are solely dedicated to Lobular & Triple Negative research.

    Let me repeat that.

    This Europe based group called "RATHER" is only focused on ILC and TN.

    Late last year they launched a small clinical trial called POSEIDON to investigate a PI3K inhibitor called Taselisib (or GDC-0032). Since half of Lobular tumors have activation of the PI3K pathway, this experimental drug developed by Genentech (who invented the miracle drug Herceptin for HER2+), is thought to be a useful weapon against that pathway in ILC. It's a small study of 32 ILC patients. Nonetheless, POSEIDON is an ILC trial designed to treat patients vs. the University of Pittsburgh trial, which is great, but designed to identify biomarkers of ILC and only relevant for newly diagnosed patients.

    There's more good news to share, but I'll leave it at that for now.

    Here's the ILC Abstracts for this weekend:

    1. RATHER: High-resolution molecular profiling of invasive lobular breast cancers.
    Suet-Feung Chin, Magali Michault, Ian Majewski, Tesa M Severson, Tycho Bismeijer, Leanne De Korning, Justine Peeters, Phillip Schouten, Oscar M Rueda, Astrid Bosma, Finbarr Tarrant, Yue Fan, BeiLei He, Bernard Pereira, Helen A Bardwell, Elena Provenzano, Darran P O'Connor, Sabine Linn [Netherlands Cancer Institute], Thierry Dubois [Paris, France], Iris Simon, William Gallagher [Dublin, Ireland], Lodewyk Wessels, Rene Bernards [Amsterdam, Netherlands], Carlos Caldas [Cambridge, UK].
    (Poster Presentation: A30; Category: Animal Models)

    2. WNT4 signaling mediates endocrine response and resistance in invasive lobular carcinoma cells.
    Matthew J Sikora, Amir Bahreini, Caroline M Alexander, Steffi Oesterreich.
    (Poster Presentation: A35; Category: Luminal Breast Cancer)

    3. Evaluation of the pathologic predictors of treatment response to neoadjuvant chemotherapy for invasive lobular breast cancer.
    Michaela L Tsai, Marsha J Finkelstein, Tamera J Lillemoe, Barbara Susnik, Erin Grimm, Sung-Hae Kang, Caitlin Kelly, Karen K Swenson.
    (Poster Presentation: A57; Category: Other)

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  • JerseyGirl22
    JerseyGirl22 Member Posts: 342
    edited October 2015

    As usual, JohnSmith, you are a wonder of research and knowledge! Thanks for putting this out here!


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  • JohnSmith
    JohnSmith Member Posts: 651
    edited December 2015

    Quick reminder.

    The annual San Antonio Breast Cancer Symposium (SABCS) starts this week. This is the most important conference of the year.

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  • JohnSmith
    JohnSmith Member Posts: 651
    edited December 2015

    Below is the Abstract to the Lobular presentation yesterday. There is a video of this, but it's behind a paywall, here.
    Also, this European study refers to "ILC" as "ILBC".

    [S1-02] "Lymphocytic infiltration in invasive lobular breast cancer"

    Authors: Desmedt C, Salgado R, Buisseret L, Zoppoli G, Fornili M, Van den Eynden G, Garaud S, Gundem G, Rothé F, Brown D, Kheddoumi N, Rouas G, Galant C, Bertucci F, Piccart M, Campbell P, Viale G, Larsimont D, Willard-Gallo K, Biganzoli E, Pruneri G, Sotiriou C.
    Institution: Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; University of Genoa, Genoa, Italy; University of Milan and Istituto Nazionale Tumori, Milan, Italy; Universiteit Antwerpen, Antwerp, Belgium; Cancer Genome Project, Wellcome Trust Sanger Institute, Hinxton, United Kingdom; Université Catholique de Louvain, Brussels, Belgium; Institut Paoli-Calmettes, Marseille, France; European Institute of Oncology, Milan, Italy

    Background: The presence and prognostic value of tumor infiltrating lymphocytes (TILs) in invasive breast carcinoma has been demonstrated in several studies, especially in the triple-negative and HER2-positive subtypes. So far, TILs have not been investigated with sufficient detail in invasive lobular breast cancer (ILBC).
    Here we therefore aimed at:
    First, assessing the distribution of stromal TILs in ILBC;
    Second, correlating the presence of TILs with standard clinical and pathological markers;
    Third, exploring associations of TILs with recurrent genomic alterations; and,
    Fourth, comparing the lymphocytic composition of ER-positive/HER2-negative lobular to ER-positive/HER2-negative ductal tumors.

    Material and methods: The percentage of stromal TILs was independently assessed according to Salgado et al. (Ann Oncol 2015) by three pathologists on full-face hematoxylin and eosin slides in a well-annotated retrospective series of 614 primary ILBCs previously characterized at the genomic level. The median value of TILs was used for the analyses. For the association analyses, we focused on the more homogeneous group of ER-positive/HER2-negative ILBC (555/614). Breast cancer-free interval was used as survival endpoint and the analyses were censored at 12 years of follow-up. The comparison of the lymphocytic composition (relative percentage of CD45+ TILs which are CD4+, CD8+ or CD19+) was assessed by FACS in a separate prospective cohort of 51 ER-positive/HER2-negative lobular and 112 ER-positive/HER2-negative ductal tumors.

    Results: The intraclass correlation coefficient between the three pathologists was 0.71 (95%CI:0.65-0.76). The median percentage of stromal TILs was 5% and the interquartile range 5-10%, with only 9% of the samples having ≥ 20%. Greater numbers of TILs were significantly associated with younger age at diagnosis, axillary lymph node involvement, high proliferative tumors as assessed by Ki67, and with the mixed non-classic ILBC subtypes. Greater numbers of TILs were associated with worse prognosis (HR=1.22; 95%CI:1.07-1.38, p=0.003) only in the unadjusted analysis, as it lost significance after adjustment for standard clinical and pathological variables. Greater numbers of TILs were observed in tumors harboring ARID1A, BRCA2, KMT2C and TP53 mutations, as well as chr3p21.31 and chr8q24.23 (PTK2) loss; whereas lower numbers were observed in tumors with ERBB3 mutations as well as chr7p and chr11q14.1 (PAK1) gains. There were no significant differences in the relative proportion of CD4+, CD8+ or CD19+ lymphocytes between ER-positive/HER2-negative lobular and ductal tumors.

    Conclusion: In this work, which reports to our knowledge on the largest series of ILBC ever assessed for TILs, we showed that most ILBCs were characterized by low lymphocytic infiltration. Besides the association of TILs with clinical and pathological features of ILBC patients, we found that higher TIL levels were observed in the presence of specific mutations and copy number alterations. Higher numbers of TILs were associated with worse prognosis at the univariate analysis. Finally, based on the assessed markers, we have no evidence of differential lymphocytic composition between ER-positive/HER2-negative lobular and ductal tumors.

    * Please PM me if you need the email for the PI (Dr. Christine Desmedt).

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  • Anonymous
    Anonymous Member Posts: 1,376
    edited December 2015

    I hope someone can translate the above post into plain English. I think the news above didn't sound so positive, but I'd like a bit of explanation.

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  • Leslie13
    Leslie13 Member Posts: 202
    edited December 2015
    TILs are Tumor infiltrating lymphocytes, which is a white cell that can destroy cancer cells. Stromal means in the connective tissue. Tissue markers are genes in our DNA. Certain ones mentioned above commonly have mutations that can cause Cancer. Their presence or absence and mutations are used in Oncotyping and other prediction tools for usefulness of certain therapies and risk of recurrence.

    Cancer therapy for other types sometimes will grow and infuse TILs to more effectively kill cancer cells.

    The simplest explanation is that less TILs found means less invasive cancer. More TILs mean the body's fighting harder, indicating a more invasive Lobular cancer.

    One problem with Lobular cancer is predicting how "bad" it is, and likelihood of recurrence. By measuring TILs it gives Providers another tool to gage the severity of Lobular cancer. And we need them!

    Thanks John for all your research. Sorry for my belated response, but this month is running away from me.
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  • fltchr
    fltchr Member Posts: 40
    edited December 2015

    Would TILs havebeen measured at any time during all the testing they do? Would an oncotype report show it? Or is it something we would need to ask for?

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  • BarredOwl
    BarredOwl Member Posts: 2,433
    edited December 2015

    Hi fltchr:

    This appears to be early stage exploratory biomarker work searching for associations. So I believe the answers to your questions are:

    1. Would TILs have been measured at any time during all the testing they do? No, this is not routinely done at this time.

    2. Would an oncotype report show it? No, because OncotypeDX uses RT-PCR on RNA from tumor cells to determine expression levels of specific genes (how active are the genes). Oncotype does not look for the presence of or count types of immune cells infiltrating the tumor (TILs), which was assessed in this study by staining (pathology assessment) and cell sorting (FACS, to identify specific types of immine cells).

    3. Or is it something we would need to ask for? No need to ask, because it is not yet available. It will be many years before any possible correlation is extended, the clinical and predictive value determined and confirmed, test validated, approved, and made commercially available (if at all).

    No action needed at this time by patients.

    BarredOwl

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  • JohnSmith
    JohnSmith Member Posts: 651
    edited December 2015

    Yes. What BarredOwl said.
    This is pure lab research. In fact, none of the Lobular SABCS topics above have any clinical relevance, yet.
    We need Lobular clinical trials to change breast cancer guidelines. One thing that could change is if Lobular subtype analysis data emerges from a Phase III trial that is statistically significant. However, I'm not aware of any such planned analysis, so the status quo will likely continue.
    There may be drugs that get approved which benefit the Lobular cohort, but those surprises would probably be purely coincidence, since no existing late stage drug trials target Lobular molecular characteristics.

    The hope is that the SABCS research above will lead to clinical trials someday.

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  • Anonymous
    Anonymous Member Posts: 1,376
    edited December 2015

    Thanks for the clarification. I'll view this news as neutral and try not to obsess about it, then.

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