Triple-negative breast cancer (TNBC) is the most aggressive breast cancer subtype and is associated with high recurrence rates, a high incidence of distant metastases and poor overall survival. The aim of this study was to investigate the role of PD-L1, EGFR and AR expression in TNBC promotion and progression. To that end, we analyzed the immunohistochemical expression of these genes in 125 TNBC patients and their relation to clinicopathological parameters and survival. An elevated expression of PD-L1 was significantly correlated with higher tumor and nuclear grade, while a low expression was correlated with loco-regional recurrence without any influence on survival. Contrary to this, the expression of AR showed a positive impact on the DFI and a negative association with tumor grade. Furthermore, PD-L1 and AR demonstrated simultaneous expression, and further co-expression analysis revealed that a positive expression of PD-L1/AR notably correlates with tumor and nuclear grade and has a significant impact on a longer DFI and OS, while a negative PD-L1/AR expression is significantly associated with metastases. Therefore, our results suggest that positive PD-L1/AR expression is beneficial for TNBC patients. In addition, an elevated expression of EGFR contributes to metastases and a worse DFI and OS. In conclusion, we think that low PD-L1/low AR/high EGFR expression followed by high Ki67 expression constitutes a ‘high risk’ profile of TNBC.

Background/Objectives: Triple-negative breast cancer (TNBC) is characterized by the absence of the expression of estrogen receptors, progesterone receptors, and human epidermal growth factor receptor 2. As there are no specific targeted therapies, TNBC patients often face an aggressive clinical course. The expression of the androgen receptor (AR) has been found in up to 30% of TNBC cases, but the association between the AR status and survival rates in TNBC remains controversial. The aim of this study was to explore the association of AR expression with the disease outcome in patients with early TNBC within a 5-year follow-up. Methods: AR expression was determined by immunohistochemistry in a cohort of 124 early-TNBC patients treated at the Institute for Oncology and Radiology of Serbia. The cut-off value used for the positive AR status was >10% tumor cells. The association of the AR status with clinicopathological factors (age, stage, tumor diameter, lymph node invasion, metastatic spread, Ki-67 score, EGFR score, and cytokeratin 5/6 score) and the disease outcome (disease-free survival—DFS—and overall survival—OS) was investigated. Results: Our analysis showed that the AR-positive status was associated with a significantly lower Ki-67 score compared to the AR-negative samples. A univariate analysis indicated that the age, tumor size, nodal status, and EGFR score significantly influenced both 5-year DFS and OS. Multivariate Cox analysis suggested that a smaller tumor size, lower nodal status, and AR expression were independent predictors of longer survival rates in TNBC patients. Conclusions: The results of this study suggest that the positive AR status may be a favorable prognostic factor in TNBC patients within the first five years after surgery.

Introduction: This study aimed to present our experience with HITHOC in the field of multimodality treatment of heterogeneous, potentially resectable, chemotherapy-sensitive pleural malignancies-primary and metastatic-limited to the unilateral thoracic inlet. Methods: The research included all patients who underwent a HITHOC procedure with CRS at the Institute for Oncology and Radiology of Serbia from January 2018 to December 2024. The indications for procedure were: resectable chemo-sensitive primary or residual/recurrent thoracic malignancies confined to one side of the thorax, and various metastatic diseases restricted to the unilateral thoracic inlet with achieved local disease control. HITHOC was performed with cisplatin (100 mg/m2 in 1000 ml of 5 % glucose, gradually heated to 42 °C) perfusion lasting 90 minutes. Results: Eleven patients were included in the study, with a mean age of 48.27 ± 18.37 years. The most common tumor pathology was thymoma, followed by malignant pleural tumors. Other tumor pathologies included ovarian cancer, Ewing's sarcoma, alveolar rhabdomyosarcoma, and lung cancer. Average follow-up was 41,73 (median: 35; range: 2-72) months. The overall survival rate was 64%. Conclusion: HITHOC procedure can be regarded as a safe, feasible, and effective approach for well-selected patients. It could be beneficial not only for its current indications, but also for chemosensitive pleural malignancies, both primary and metastatic, limited to the unilateral thoracic inlet.