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Showed that immune cells inside breast tumours predict outcome, the basis for de-escalating chemotherapy in TNBC.
Sherene Loi is Professor and Head of the Translational Breast Cancer Genomics and Therapeutics Laboratory at the Peter MacCallum Cancer Centre in Melbourne, where she is also a medical oncologist. Her work on tumour-infiltrating lymphocytes established them as a prognostic and predictive biomarker in breast cancer, showing that immune cells inside tumours predict outcome and underpinning current efforts to spare patients with stage I triple-negative breast cancer from chemotherapy. Her publications include a pooled individual patient analysis of tumour-infiltrating lymphocytes and prognosis in early-stage triple-negative breast cancer. She leads immunotherapy trials, including work connected to KEYNOTE-522, and chairs the International Immuno-Oncology Biomarker Working Group.
| Title | Journal | Year |
|---|---|---|
| Tumor-infiltrating lymphocytes and prognosis: a pooled individual patient analysis of early-stage triple-negative breast cancers | Journal of Clinical Oncology | 2019 |
| NATALEE: three years of ribociclib after surgery in a broad population of hormone-receptor-positive early breast cancer | New England Journal of Medicine | 2024 |
Ribociclib is a second adjuvant CDK4/6 option, and the only one with data in node-negative stage II disease. Roughly 3 in 100 patients avoid a relapse or death at three years, so the decision depends heavily on individual risk, tolerance of a three-year oral drug, and cost. Whether the benefit persists after treatment ends, as it did with abemaciclib, needs longer follow-up.
The evidence behind the stage I de-escalation statement on the triple-negative page: an ordinary haematoxylin and eosin slide identifies a fifth of patients whose outcome without chemotherapy matches treated cohorts. A prospective trial of chemotherapy omission is the missing step.
The clearest demonstration that PD-L1 positive in triple-negative breast cancer means different things depending on the kit; with atezolizumab withdrawn, pembrolizumab's 22C3 combined positive score of 10 is the surviving standard, and roughly a quarter of patients get a different answer depending on which assay their laboratory runs.
TILs are prognostic without chemotherapy, which is what a de-escalation biomarker has to show before trials omit treatment on its basis.
TILs are the strongest cheap prognostic biomarker in early TNBC, scored on a standard slide, and the basis of the de-escalation trials that omit chemotherapy in small, lymphocyte-rich tumours.
Shares Breast Cancer Trials, Peter MacCallum Cancer Centre, HR-positive / HER2-negative breast cancer.
Shares Tumor-Infiltrating Lymphocytes in Triple-Negative Breast Cancer, Tumour-infiltrating lymphocytes (TILs), Triple-negative breast cancer (TNBC).
Shares Breast Cancer Trials, Triple-negative breast cancer (TNBC), HR-positive / HER2-negative breast cancer.
Shares Breast Cancer Research Foundation, Triple-negative breast cancer (TNBC), HR-positive / HER2-negative breast cancer.
Shares Breast Cancer Research Foundation, Triple-negative breast cancer (TNBC), HR-positive / HER2-negative breast cancer.
Shares Tumour-infiltrating lymphocytes (TILs), KEYNOTE-522, Triple-negative breast cancer (TNBC), Immune checkpoint inhibitors.
Shares Prognostic value of tumor-infiltrating lymphocytes in patients with early-stage triple-negative breast cancers (TNBC) who did not receive adjuvant chemotherapy, Tumor-Infiltrating Lymphocytes in Triple-Negative Breast Cancer, Triple-negative breast cancer (TNBC), HR-positive / HER2-negative breast cancer.
Shares Tumor-Infiltrating Lymphocytes in Triple-Negative Breast Cancer, Tumour-infiltrating lymphocytes (TILs), KEYNOTE-522, Triple-negative breast cancer (TNBC).