Relevance of T Lymphocytes Tumor Infiltrates CD8 and Foxp3 as Immune Prognostic Biomarker in Breast Cancer Treated by Neo Adjuvant Chemotherapy
Relevance of T Lymphocytes Tumor Infiltrates CD8 and Foxp3 as Immune Prognostic Biomarker in Breast Cancer Treated by Neo Adjuvant Chemotherapy
Neoadjuvant chemotherapy is standard therapy for the management of localised breast cancer,
 and makes it possible to evaluate tumour response. Achieving pathological complete response
 (pCR) after chemotherapy is the most important prognostic factor for these patients. However,
 patients with pCR can suffer relapse. In parallel, long-term prognosis of patients who do not
 achieve pCR is poorly documented, and no specific prognostic factors have been clearly
 identified.Preclinical and clinical studies argue for an immunogenic role of some
 chemotherapy regimens, such as anthracyclines, taxanes or trastuzumab. By facilitating
 recruitment of CD8 T-lymphocytes in the tumour bed, these agents could favourably influence
 antitumour immune response, partially contributing to efficacy. Conversely, tumours can
 promote accumulation of regulatory T-lymphocytes expressing Foxp3, thus evading anti-tumour
 immune response, and increased numbers of regulatory T-cells are associated with less
 favourable prognosis in breast cancer patients. We have previously shown that a high number
 of CD8 T-cells associated with low Foxp3 infiltration, as quantified by immunohistochemistry
 on surgical specimens, is associated with better response and better survival in breast
 cancer patients, independently of whether pCR was achieved, the type of chemotherapy used,
 and the type of breast cancer. Therefore, we propose to validate in a prospective study this
 immunological prognostic marker in a large cohort of patients treated with neoadjuvant
 chemotherapy.
inclusion criteria

 1. Signed informed consent

 2. Social security coverage

 3. Age between 18 and 80 years

 4. Histologically proven breast cancer, regardless of histological type or molecular
 subtype (triple negative, hormone-receptor positive, HER2+++), including inflammatory
 forms

 5. Localised breast cancer with or without axillary or subclavicular lymph node
 involvement

 6. Absence of bone or visceral metastasis on further evaluation (bone scintigraphy, chest
 X-ray, abdominal echocardiography or CT scan of the thorax, abdomen and pelvic area)

 7. Treatment by neoadjuvant chemotherapy (treatment protocol at physician's discretion)

 8. Patient amenable to receiving adjuvant therapy (chemotherapy, radiotherapy, hormone
 therapy, targeted therapy)

 9. Breast surgery (breast-sparing or not) planned after neoadjuvant chemotherapy

 exclusion criteria

 1. Metastatic breast cancer

 2. Neoadjuvant radiotherapy

 3. Patient not amenable to surgery

 4. Ongoing therapy for any other type of cancer

 5. Legal incapacity (incarceration or persons under legal guardianship)

 6. Patient unable to sign the informed consent or unable to attend medical follow-up for
 geographical, social or mental reasons.