About this trial
This retrospective observational study aims at the comparison of the tumour-microenvironment tissue architecture before and after neo-adjuvant therapy in samples from HER2-positive (HER2+) breast cancer (BrCa) patients that display residual invasive disease in the breast/lymph node at surgery after standard-of-care combined chemotherapy and trastuzumab treatment.
The working hypothesis of the investigators is that:
Therapy imposes a selective pressure on tumour-microenvironment features promoting resistance to treatment.
Participant that have already undergone neo-adjuvant treatment as part of their regular medical care for HER2-positive breast cancer will provide access to formalin-fixed paraffin-embedded (FFPE) samples taken before and after therapy.
Tumoral, peri-tumoral and stromal regions of each specimen will be analyzed with the ultimate goal to identify new biomarkers (and putative targets) of resistance to therapy.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Participant is willing and able to give informed consent for participation in the study.
Patient underwent the following procedure before surgery: biopsy, sequential chemotherapy comprising treatment with antracyclines (AC/EC q21, 4 cycles) followed by taxanes (paclitaxel 1,8,15 q21 for 12 weeks) in combination with the anti-HER2 antibody trastuzumab.
Specimen collected at surgery display residual invasive disease in the breast/lymph node.
Disqualifiers
pre-existing conditions or concurrent diagnoses;
concomitant use of other medications during neo-adjuvant treatment;
quality of stored specimen does not meet the standard for Imaging Mass Cytometry analysis.
Trial population
HER2+ Breast Cancer patients displaying residual invasive disease in the breast/lymph node at surgery after neo-adjuvant treatment \[sequential chemotherapy comprising treatment with antracyclines (AC/EC q21, 4 cycles) followed by taxanes (paclitaxel 1,8,15 q21 for 12 weeks) in combination with the anti-HER2 antibody trastuzumab\].
Trial design
Cohort
Retrospective
Treatments tested in this trial
Not listed
Trial groups
Trial outcomes
Primary outcomes
number of different cells per each phenotype
Cell types will be classified based on the expression of specific lineage/phenotype markers.
density of each phenotype
Cell phenotype densities will be calculated by dividing the number of total cells counted by the total area of the tissue acquired.
fraction of proliferative/active cells of each phenotype
The proportion of cells positive for the proliferation marker Ki67 will be assessed per cell phenotype. To assess the proportion of active immune cells, we will quantify the expression level of activation markers.
frequency of interactions
Cells will be defined as partaking in an interaction if their whole-cell profiles are in direct contact (contiguous pixels). Cell phenotypes will be mapped to cell-cell interaction masks, and for each specimen proximity events (cell-cell interactions) will be classified as homotypic or heterotypic proximity events
Sponsors and contacts
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Giampaolo Bianchini
Lead sponsor
IRCCS Ospedale San Raffaele
Sponsor institution