The prognostic values of FOXP3+ tumor-infiltrating T cells in breast cancer: a systematic review and meta-analysis.

Abstract

BACKGROUND:

Tumor microenvironment is infiltrated by many immune cells, of which Regulatory T (Treg) cells are usually considered as negative regulators of the immune responses. However, the effect of FOXP3+ (forkhead box transcription factor 3) Treg cells infiltrated into the tumor areas on the prognosis of breast cancer is controversial. This meta-analysis aimed to dissect the potential values of FOXP3+ tumor-infiltrating lymphocytes (TILs) as a prognosis predictor of breast cancer.

METHODS:

After systematic retrieval of all relevant studies, 28 eligible articles were identified for meta-analysis. Odd ratio (OR), hazard ratio (HR), and 95% confidence interval (CI) were obtained for pooled analyses of pathological complete response (pCR), overall survival (OS), and corresponding forest plots and funnel plots were plotted, respectively.

RESULTS:

Pooled results revealed that patients with higher levels of FOXP3+ TILs experienced better pCR (OR: 1.24, 95% CI 1.09-1.41) and OS (HR: 0.79, 95% CI 0.64-0.97). Subgroup analysis revealed that elevated FOXP3+ TILs were significantly associated with improved pCR (OR: 1.20, 95% CI 1.02-1.40) and OS (HR: 0.22, 95% CI 0.06-0.88) in human epidermal growth factor receptor 2 positive (HER2+) breast cancer patients. Furthermore, FOXP3+ TILs in the stromal area were statistically correlated with the favorable pCR (OR: 1.22, 95% CI 1.08-1.38) and OS (HR: 0.68, 95% CI 0.49-0.96).

CONCLUSIONS:

The predictive role of FOXP3+ TILs in the prognosis of breast cancer is influenced by various factors such as molecular subtype of breast cancer and the location of Treg. In HER2+ breast cancer and triple-negative breast cancer, FOXP3+ TILs are associated with better pCR and OS. Additionally, FOXP3+ TILs in stromal represent a favourable prognosis.

• Authors: Yalan Sun, Ying Wang, Fang Lu, Xianghong Zhao, Zhenlin Nie, Bangshun He
• Journal: Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico (Clin Transl Oncol) Vol. 25 Issue 6 Pg. 1830-1843 (Jun 2023) ISSN: 1699-3055 [Electronic] Italy
• PMID: 36692642 (Publication Type: Meta-Analysis, Systematic Review, Journal Article, Review)
• Copyright: © 2023. The Author(s), under exclusive licence to Federación de Sociedades Españolas de Oncología (FESEO).

Chemical References

• Forkhead Transcription Factors
• FOXP3 protein, human

Topics

• Humans
• Female
• Breast Neoplasms (pathology)
• Prognosis
• Lymphocytes, Tumor-Infiltrating (metabolism)
• Triple Negative Breast Neoplasms (pathology)
• T-Lymphocytes, Regulatory (pathology)
• Forkhead Transcription Factors (metabolism)
• Tumor Microenvironment