Prognostic Value of Ki67 and Tumor-Infiltrating Lymphocytes in Residual Tumor Following Neoadjuvant Chemotherapy for TNBC
Key Clinical Takeaways
- Combined assessment of Ki67 and tumor-infiltrating lymphocytes (TILs) in residual tumor meaningfully improves prognostic precision for patients with triple-negative breast cancer who do not achieve pCR after neoadjuvant chemotherapy.
- Low post-treatment Ki67 (≤15%) and higher TIL levels (≥50%) were associated with the most favorable 5-year distant disease-free and overall survival outcomes.
- Patients with limited residual disease (ypT1, ypN0) experienced markedly better survival, with Ki67 emerging as an independent predictor of outcome even within this favorable subgroup.
- Findings support the integration of Ki67 and TILs into post-neoadjuvant risk stratification models to guide more personalized treatment decisions in TNBC.
Johannes Holtschmidt, MD, German Breast Group, Offenbach, Germany, discusses results from a pooled analysis of 9 GBG/AGO-B neoadjuvant trials evaluating whether Ki67 and tumor-infiltrating lymphocytes (TILs) in residual tumor can improve prognostic assessment for patients with triple-negative breast cancer (TNBC) who do not achieve a pathologic complete response (pCR) after neoadjuvant chemotherapy.
Lower post-treatment Ki67 and higher TIL levels were strongly associated with superior distant disease-free and overall survival, with the most favorable outcomes observed when both biomarkers were combined, supporting their potential role in refining post-neoadjuvant risk stratification and guiding treatment selection.
These findings were presented at the 2025 San Antonio Breast Cancer Symposium in San Antonio, Texas.
Source:
Holtschmidt J, Schneeweiss A, Frickel N, et al. Prognostic markers in residual tumors after neoadjuvant chemotherapy (NACT) for early triple-negative breast cancer (TNBC) – A pooled analysis from nine neoadjuvant GBG/AGO-B trials. Presented at SABCS 2025. December 9 - 12, 2025. San Antonio, Texas. Abstract RF2-01
