Tumor-infiltrating lymphocyte (TILs) proportion and spatial location within the TME are evaluated in all breast cancer subtypes, where we show a higher number of TNBC patients had intra - tumoral TILs - an observation unique to the cohort from India. Within TNBC, a higher proportion of stromal TILs predicted better response to chemotherapy and longer disease-free survival.

To further characterize the Tumor Immune Microenvironment (TIME), cutting-edge technologies are being used, like multiplex staining using Akoya’s Opal kit, multispectral image acquisition with a whole slide fluorescent scanner, Leica Aperio VERSA and phenotyping immune cell types using HALO Indica platform. In addition to identifying the proportion of each subtype, spatial correlation with respect to tumor is being analysed.

Tumor and TILs percent scoring by the pathologist is subjective and requires advanced training. For consistency in reliable quantitative scores, we are developing a machine-learning model using the WSI archival H&E images.

EGFR/AR - Profiling TNBC based on known prognostic and therapeutic markers such as EGFR and AR will help us determine the targetable subsets of TNBC. We found that many of our TNBC tumors are EGFR +ve and AR +ve. AR-positivity is higher in our cohort than in reported studies and is associated with poor survival rates.

YAP - YAP1, a transcriptional co-activator, has been studied as an oncogene in multiple cancer types, which is involved in tumor growth, invasion, metastasis and therapy resistance. The primary objective of the project is to identify the prognostic significance of YAP1 in breast cancer subtypes.