• Masanori Oshi, Rongrong Wu, Thaer Khoury, Shipra Gandhi, Li Yan, Akimitsu Yamada, Takashi Ishikawa, Itaru Endo, and Kazuaki Takabe.
• Department of Surgical Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, NY.
• Ann. Surg. 2024 Oct 1; 280 (4): 557569557-569.

ObjectiveTo investigate the clinical relevance of common myeloid progenitor (CMP) cells in breast tumor microenvironment (TME).BackgroundThe role of rare cells in TME is less studied. In Silico transcriptomic analyses of real-world data enable us to detect and quantify rare cells, including CMP cells.MethodsA total of 5176 breast cancer (BC) patients from SCAN-B, METABRIC, and 5 single-cell sequence cohorts were analyzed using the xCell algorithm. The high group was defined as more than two-thirds of the CMP scores in each cohort.ResultsCMP cells consist of 0.07% to 0.25% of bulk breast tumor cells, more in estrogen receptor-positive (ER+) compared with triple-negative (TN) subtype (0.1% to 0.75%, 0.18% to 0.33% of immune cells, respectively). CMP cells did not correlate with any of the myeloid lineages or stem cells in TME. CMP infiltration was higher in smaller tumors, with lower Nottingham grade, and in ER+/HER2- than in TNBC consistently in both SCAN-B and METABRIC cohorts. High CMP was significantly associated with a lower risk of brain metastasis and with better survival, particularly in ER+/HER2-. High CMP enriched epithelial-to-mesenchymal transition and angiogenesis pathways, and less cell proliferation and DNA repair gene sets. High CMP ER+/HER2- was associated with less immune cell infiltration and cytolytic activity ( P <0.001). CMP infiltration correlated with neoadjuvant chemoimmunotherapy response for both ER+/HER2- and TNBC in the ISPY-2 cohort (AUC=0.69 and 0.74, respectively).ConclusionsCMP in BC is inversely associated with cell proliferation and brain metastasis, better response to immunotherapy, and survival. This is the first to report the clinical relevance of CMP infiltration in BC.Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.

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