PROGNOSTIC ROLE OF RESIDUAL TUMOR FEATURES IN HER2-NEGATIVE BREAST CANCER.

The aim of the study was to examine the prognostic value of immunobiological markers (tumor-infiltrating lymphocytes (TILs) and their subpopulations) in residual tumor after neoadjuvant chemotherapy (NACT) completion in patients with triple negative (TNBC) and luminal B HER2-neu negative breast cancer (LBBC). MATERIALS AND METHODS: The analysis of the treatment results of 59 patients with TNBC and 56 patients with LBBC with stage IIB-IIIB who received NACT was performed. The levels of TILs and their subpopulations (FOXP3+, CD4+, CD8+) in patients at the time of diagnosis in core-needle biopsy material and in residual tumor in postoperative material were studied by immunohistochemical method. RESULTS: The risk of recurrence in patients with LBBC who received NACT before surgery is associated mainly with 4 factors: FOXP3+ lymphocytes, Ki-67 index in residual tumor, the number of affected axillary lymph nodes after NACT and viable residual tumor volume. Analysis of the treatment outcome in patients with TNBC revealed that the lack of pathologic complete response (pCR) after NACT increases the risk of disease recurrence by 2.9 times, hazard ratio (HR) = 2.9 (95% confidence interval (CI) 1.4-6.1; p = 0.005) compared with patients in which pCR was achieved after NACT. It was also found that the presence of residual tumor in patients with TNBC after NACT increases the risk of death from this disease by 2.7 times (95% CI 1.0-7.1; p = 0.05). Increased intratumoral and stromal CD8+ lymphocyte counts in the residual tumor after NACT significantly reduces the risk of death from TNBC, HR = 0.6 (95% CI 0.5-0.9; p = 0.01) and HR = 0.6 (95% CI 0.4-0.9; p = 0.008), respectively. Increase in intratumoral CD4+ lymphocytes in residual tumor in the non-pCR group reduces by half the risk of death from TNBC, HR = 0.5 (95% CI 0.3-1.0; p = 0.05). CONCLUSION: The results of our study indicate a favorable prognostic value of TILS in residual tumor in TNBC. It is also reasonable to include the determination of the level of FOXP3+ lymphocytes in the residual tumor in the standard algorithms for stratification of risk groups.

MALIGNANT TUMORS IN PEDIATRIC POPULATION OF UKRAINE: TRENDS AND STRUCTURAL FEATURES.

The creation of a central bank of personalized information of cancer patients, including children, allowed to obtain objective data and establish continuous cancer surveillance in the child population in Ukraine. The aim of the study was to analyze the dynamics of cancer incidence (1989-2019) and mortality (1999-2019) based on the 3rd revision of International Classification of Childhood Cancer (ICCC-3). MATERIALS AND METHODS: A study cohort includes 31,537 patients aged 0-19 years at the time of diagnosis in 1989-2019, registered in Ukrainian population. RESULTS: The major groups of malignancies in the child population are presented by leukemia, lymphomas, central nervous system (CNS) tumors, epithelial neoplasms, bone cancer and soft tissues sarcomas. There were observed no gender differences in cancer incidence, except germ cell tumors and trophoblastic tumors, gonadal malignancies, as well as some other malignant epithelial neoplasms, with their proportion being twice higher in the female population. Our analysis showed a trend towards increase in the incidence of leukemia, CNS neoplasms, neuroblastoma, trophoblastic tumors and epithelial malignancies; decrease in the incidence of lymphomas and bone neoplasms; stabilization in the incidence of malignancies of liver and kidneys. The dynamic changes in cancer mortality in the studied cohort were observed, namely, the decrease of mortality from leukemias and lymphomas in males (but not in females), along with the increase of mortality from CNS neoplasms, neuroblastoma, soft tissues sarcomas and germ cell tumors, regardless of gender. CONCLUSIONS: The analysis and presentation of the epidemiological data on children's malignancies implementing ICCC-3 classification for all relevant records in the National Cancer Registry of Ukraine allows for evaluating the major trends of cancer incidence and mortality in Ukrainian pediatric population, taking into account tumor morphology, topography, gender and age.