The Indonesian Biomedical Journal
Vol 17, No 3 (2025)

Expression of CD8+ and Foxp3+ T Lymphocyte as Predictor for Response to Neoadjuvant Chemotherapy in Stage III Breast Cancer

I Nyoman Wawan Tirtha Yasa (Doctoral Study Program, Faculty of Medicine, Universitas Udayana, Jl. P.B. Sudirman, Denpasar 80232)
I Wayan Sudarsa (Division Surgical Oncology, Departement of Surgery, Faculty of Medicine, Universitas Udayana, Jl. P.B. Sudirman, Denpasar 80232)
I Wayan Niryana (Department of Neurosurgery, Faculty of Medicine, Universitas Udayana, Jl. P.B. Sudirman, Denpasar 80232)
Ni Putu Sriwidyani (Department ofAnatomical Pathology, Faculty of Medicine, Universitas Udayana, Jl. P.B. Sudirman, Denpasar 80232)
I Made Jawi (Department of Pharmacology, Faculty of Medicine, Universitas Udayana, Jl. P.B. Sudirman, Denpasar 80232)
I Wayan Putu Sutirta Yasa (Department of Clinical Pathology, Faculty of Medicine, Universitas Udayana, Jl. P.B. Sudirman, Denpasar 80232)
Ida Bagus Tjakra Wibawa Manuaba (Division Surgical Oncology, Departement of Surgery, Faculty of Medicine, Universitas Udayana, Jl. P.B. Sudirman, Denpasar 80232)
Ida Bagus Made Suryawisesa (Division Surgical Oncology, Departement of Surgery, Faculty of Medicine, Universitas Udayana, Jl. P.B. Sudirman, Denpasar 80232)



Article Info

Publish Date
17 Jun 2025

Abstract

BACKGROUND: Neoadjuvant chemotherapy (NAC) in breast cancer is usually utilized to eradicate micro-metastasis, induce apoptosis in tumor cells, and reduce the primary tumor size, enabling surgical intervention. Recent studies have shown that tumor-infiltrating lymphocytes (TILs), especially cytotoxic CD8+ T cells and immunosuppressive Foxp3+ regulatory T cells, influence tumor response to treatment. However, their role as predictive markers for NAC response remains unclear. Therefore, this study was performed to investigate whether high expression of CD8+ and low expression of Foxp3+ T lymphocytes are associated with better response to NAC in stage III breast cancer patients.METHODS: Total of 60 biopsy samples from stage III breast cancer patients were included, comprising 30 subjects in the response group (+) and 30 subjects in the non-response group (−). The expression levels of CD8+ and Foxp3+ T lymphocytes in tumor tissue were assessed semi-quantitatively by immunohistochemistry (IHC), using a scoring system based on the proportion and intensity of positively stained cells (Black’s grading criteria).RESULTS: Stage III breast cancer with high expression of CD8+ T lymphocytes was significantly associated with a better response to NAC (p=0.004; OR=6.882). Meanwhile, low expression of Foxp3+ T lymphocytes was not significantly associated with chemotherapy response (p=0.067; OR=3.250). A higher tumor grade was also associated with an improved response to treatment. The probability of achieving a positive response to NAC in subjects presenting with high CD8+ expression, low Foxp3+ expression, and high tumor grade was estimated at 96.98%.CONCLUSION: The combination of high expression of CD8+ T lymphocyte, low expression of Foxp3+ T lymphocyte and high tumor grade might be useful to predict good response to NAC in stage III breast cancer.KEYWORDS: CD8+ T lymphocyte, Foxp3+ T lymphocyte, neoadjuvant chemotherapy, breast cancer

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