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Journal of Immunology Research
Volume 2016, Article ID 4757405, 25 pages
Clinical Study

Crucial Contributions by T Lymphocytes (Effector, Regulatory, and Checkpoint Inhibitor) and Cytokines (TH1, TH2, and TH17) to a Pathological Complete Response Induced by Neoadjuvant Chemotherapy in Women with Breast Cancer

1Division of Gastrointestinal Surgery, Nottingham Digestive Diseases Centre, Faculty of Medicine and Health Sciences, University of Nottingham, E Floor, West Block, Queen’s Medical Centre, Derby Rd, Nottingham NG7 2UH, UK
2Research & Development Department, Lincoln Breast Unit, Lincoln County Hospital, Greetwell Road, Lincoln LN2 5QY, UK
3Department of Pathology, PathLinks, Lincoln County Hospital, Greetwell Road, Lincoln LN2 5QY, UK
4Academic Department of Pathology, Faculty of Medicine and Health Sciences, University of Nottingham, A Floor, West Block, Queens Medical Centre, Derby Road, Nottingham NG7 2UH, UK

Received 8 February 2016; Revised 19 August 2016; Accepted 24 August 2016

Academic Editor: Yi Zhang

Copyright © 2016 Viriya Kaewkangsadan et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Supplementary Material

Additional file 1: documents the impact of NAC on the levels of TILs between pre- and post-NAC samples. The levels of both intra-tumoural and stromal TILs were not significantly altered, when pre-NAC samples were compared with post-NAC samples. Five out of 16 patients with a high level of TILs subsequently had a low level after NAC, whilst 1 out of 16 with a low level of TILs had a higher level post-NAC (p=0.219). Additional file 2: prior to NAC, there was no significant correlation between the levels of circulating Tregs and those in the tumour microenvironment. Following NAC, however, there was a significant positive correlation between the % of circulating and intra-tumoural FOXP3 Tregs. [Correlation Coefficient (rho) 0.687, p=0.003]. Additional file 3: shows no significant correlation between circulating and tumour-infiltrating CTLA-4 Tregs. Additional file 4: similar to pre-NAC tumour-infiltrating Tregs (FOXP3 and CTLA-4), the levels of pre-NAC circulating Tregs (AbNs and %) were not significantly different in any of the NAC response groups (GPR versus PPR and pCR versus non pCR, p>0.05). Additional file 5: illustrates the effect of NAC on the expression of cytokines and PD-L1 in breast cancers. There was no significant difference between pre- and post-NAC expression (p>0.05) except for IL-4. The expression of IL-4 following NAC was significantly reduced (p=0.016); in 43.8% (7 out of 16) from high to low and in no case was this reversed.

  1. Supplementary Material