Correlation of Tumor Immune Response with Prognosis in Node-Negative Breast Cancer Patients from the DBCG HYPO Randomized Trial
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By
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Demet Özcan
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Patricia Switten Nielsen
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Jan Alsner
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Mette Holck Nielsen
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Else Maae
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Marie Louise Holm Milo
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Jens Overgaard
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Birgitte Vrou Offersen
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Trine Tramm
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March 13, 2026
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Clinical Scorecard: Correlation of Tumor Immune Response with Prognosis in Node-Negative Breast Cancer Patients from the DBCG HYPO Randomized Trial
At a Glance
| Category | Detail |
|---|
| Condition | Node-Negative Breast Cancer |
| Key Mechanisms | Tumor-infiltrating lymphocytes (TILs) and immune cell subsets as prognostic and predictive biomarkers. |
| Target Population | Node-negative breast cancer patients treated with locoregional adjuvant radiotherapy. |
| Care Setting | Adjuvant treatment following breast-conserving surgery. |
Key Highlights
- Hypofractionated radiotherapy regimens show equivalent efficacy and safety compared to standard regimens.
- High levels of TILs are associated with improved prognosis in node-positive breast cancer.
- The predictive value of TILs may differ based on nodal status and ER status.
- Immune infiltration may predict differential benefit from different radiotherapy fractionation schedules.
Guideline-Based Recommendations
Diagnosis
- Evaluate TILs and immune cell subsets in tumor tissue for prognostic information.
Management
- Consider immune biomarkers in radiotherapy planning for node-negative breast cancer patients.
Monitoring & Follow-up
- Monitor loco-regional and distant recurrence, as well as breast cancer-specific mortality.
Risks
- Assess the risk of local control based on TIL levels and CD8+ T-cell counts.
Patient & Prescribing Data
Patients with T1a-T2, N0-1(mi) breast cancer.
Patients randomized to postoperative 50 Gy/25 fr versus 40 Gy/15 fr.
Clinical Best Practices
- Utilize a 30% cut-off for categorizing TIL levels to ensure reliable interobserver agreement.
- Incorporate multiplex immunohistochemistry for detailed immune profiling.
References
