Journal article
Pitfalls in assessing stromal tumor infiltrating lymphocytes (sTILs) in breast cancer
NPJ breast cancer, Vol.6(1), p.17
05/12/2020
DOI: 10.1038/s41523-020-0156-0
PMCID: PMC7217863
PMID: 32411819
Abstract
Stromal tumor-infiltrating lymphocytes (sTILs) are important prognostic and predictive biomarkers in triple-negative (TNBC) and HER2-positive breast cancer. Incorporating sTILs into clinical practice necessitates reproducible assessment. Previously developed standardized scoring guidelines have been widely embraced by the clinical and research communities. We evaluated sources of variability in sTIL assessment by pathologists in three previous sTIL ring studies. We identify common challenges and evaluate impact of discrepancies on outcome estimates in early TNBC using a newly-developed prognostic tool. Discordant sTIL assessment is driven by heterogeneity in lymphocyte distribution. Additional factors include: technical slide-related issues; scoring outside the tumor boundary; tumors with minimal assessable stroma; including lymphocytes associated with other structures; and including other inflammatory cells. Small variations in sTIL assessment modestly alter risk estimation in early TNBC but have the potential to affect treatment selection if cutpoints are employed. Scoring and averaging multiple areas, as well as use of reference images, improve consistency of sTIL evaluation. Moreover, to assist in avoiding the pitfalls identified in this analysis, we developed an educational resource available at www.tilsinbreastcancer.org/pitfalls .
Details
- Title: Subtitle
- Pitfalls in assessing stromal tumor infiltrating lymphocytes (sTILs) in breast cancer
- Creators
- Zuzana Kos - Department of Pathology, BC Cancer - Vancouver, Vancouver, BC, Canada. Zuzana.Kos@bccancer.bc.caElvire Roblin - Oncostat U1018, Inserm, University Paris-Saclay, labeled Ligue Contre le Cancer, Villejuif, FranceRim S Kim - National Surgical Adjuvant Breast and Bowel Project (NSABP)/NRG Oncology, Pittsburgh, PA, USAStefan Michiels - Oncostat U1018, Inserm, University Paris-Saclay, labeled Ligue Contre le Cancer, Villejuif, FranceBrandon D Gallas - Division of Imaging, Diagnostics, and Software Reliability (DIDSR); Office of Science and Engineering Laboratories (OSEL); Center for Devices and Radiological Health (CDRH), US Food and Drug Administration (US FDA), Silver Spring, MD, USAWeijie Chen - Center for Devices and Radiological HealthKoen K van de Vijver - Ghent UniversityShom Goel - The University of MelbourneSylvia Adams - York UniversitySandra Demaria - Cornell UniversityGiuseppe Viale - University of MilanTorsten O Nielsen - University of British ColumbiaSunil S Badve - Purdue University West LafayetteW Fraser Symmans - Department of Pathology, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USAChristos Sotiriou - Université Libre de BruxellesDavid L Rimm - Yale UniversityStephen Hewitt - Laboratory of Pathology, National Cancer Institute, NIH, Bethesda, MD, USACarsten Denkert - Universitätsklinikum Gießen und MarburgSibylle Loibl - German Breast groupStephen J Luen - The University of MelbourneJohn M S Bartlett - Ontario Institute for Cancer ResearchPeter Savas - The University of MelbourneGiancarlo Pruneri - University of MilanDeborah A Dillon - Department of Pathology, Dana Farber Cancer Institute, Boston, MA, USAMaggie Chon U Cheang - Institute of Cancer Research Clinical Trials and Statistics Unit, The Institute of Cancer Research, Surrey, UKAndrew Tutt - Breast Cancer NowJacqueline A Hall - Vivactiv Ltd, Bellingdon, Bucks, UKMarleen Kok - The Netherlands Cancer InstituteHugo M Horlings - The Netherlands Cancer InstituteAnant Madabhushi - Case Western Reserve UniversityJeroen van der Laak - Radboud University NijmegenFrancesco Ciompi - Radboud University NijmegenAnne-Vibeke Laenkholm - Zealand University HospitalEnrique Bellolio - Universidad de La FronteraTina Gruosso - Forbius, Montreal, QC, CanadaStephen B Fox - Peter MacCallum Cancer CentreJuan Carlos Araya - Universidad de La FronteraGiuseppe Floris - KU LeuvenJan Hudeček - The Netherlands Cancer InstituteLeonie Voorwerk - The Netherlands Cancer InstituteAndrew H Beck - PathAI, Inc, Boston, MA, USAJen Kerner - PathAI, Inc, Boston, MA, USADenis Larsimont - Department of Pathology, Jules Bordet Institute, Brussels, BelgiumSabine Declercq - Department of Pathology, GZA-ZNA, Antwerp, BelgiumGert Van den Eynden - Department of Pathology, GZA-ZNA, Antwerp, BelgiumLajos Pusztai - Yale UniversityAnna Ehinger - Lund UniversityWentao Yang - Fudan UniversityKhalid AbdulJabbar - Centre for Evolution and Cancer; Division of Molecular Pathology, The Institute of Cancer Research, London, UKYinyin Yuan - Centre for Evolution and Cancer; Division of Molecular Pathology, The Institute of Cancer Research, London, UKRajendra Singh - Icahn School of Medicine at Mount SinaiCrispin Hiley - University College LondonMaise Al Bakir - University College LondonAlexander J Lazar - Departments of Pathology, Genomic Medicine, Dermatology, and Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USAStephen Naber - Tufts Medical CenterStephan Wienert - Humboldt-Universität zu BerlinMiluska Castillo - Instituto Nacional de Enfermedades NeoplásicasGiuseppe Curigliano - University of MilanMaria-Vittoria Dieci - Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, ItalyCharles Swanton - University College LondonFabrice André - Institut Gustave RoussyJorge Reis-Filho - Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, NY, USAJoseph Sparano - Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USAEva Balslev - Gentofte HospitalI-Chun Chen - National Taiwan UniversityElisabeth Ida Specht Stovgaard - Gentofte HospitalKatherine Pogue-Geile - National Surgical Adjuvant Breast and Bowel Project (NSABP)/NRG Oncology, Pittsburgh, PA, USAKim R M Blenman - Yale Cancer CenterFrédérique Penault-Llorca - Centre Jean PerrinStuart Schnitt - Department of Pathology, Brigham and Women's Hospital, Boston, MA, USASunil R Lakhani - The University of QueenslandAnne Vincent-Salomon - Institut Curie, Paris Sciences Lettres Université, Inserm U934, Department of Pathology, Paris, FranceFederico Rojo - Cancer Research FoundationJeremy P Braybrooke - University Hospitals Bristol NHS Foundation TrustMatthew G Hanna - Memorial Sloan Kettering Cancer CenterM Teresa Soler-Monsó - Bellvitge University HospitalDaniel Bethmann - University Hospital Halle (Saale), Institute of Pathology, Halle (Saale), GermanyCarlos A Castaneda - Instituto Nacional de Enfermedades NeoplásicasKaren Willard-Gallo - Institut Jules BordetAshish Sharma - Department of Biomedical Informatics, Emory University, Atlanta, GA, USAHuang-Chun Lien - Department of Pathology, National Taiwan University Hospital, Taipei, TaiwanSusan Fineberg - Albert Einstein College of MedicineJeppe Thagaard - Technical University of DenmarkLaura Comerma - Cancer Research FoundationPaula Gonzalez-Ericsson - University Medical CenterEdi Brogi - Memorial Sloan Kettering Cancer CenterSherene Loi - The University of MelbourneJoel Saltz - Biomedical Informatics Department, Stony Brook University, Stony Brook, NY, USAFrederick Klaushen - Charité - Universitätsmedizin BerlinLee Cooper - Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL, USAMohamed Amgad - Emory UniversityDavid A Moore - University College London Hospitals NHS Foundation TrustRoberto Salgado - Peter MacCallum Cancer Centre
- Contributors
- International Immuno-Oncology Biomarker Working Group (Author)Andrew M Bellizzi (Contributor) - University of Iowa, Pathology
- Resource Type
- Journal article
- Publication Details
- NPJ breast cancer, Vol.6(1), p.17
- DOI
- 10.1038/s41523-020-0156-0
- PMID
- 32411819
- PMCID
- PMC7217863
- NLM abbreviation
- NPJ Breast Cancer
- ISSN
- 2374-4677
- eISSN
- 2374-4677
- Grant note
- 17-194 / Breast Cancer Research Foundation (BCRF)
- Language
- English
- Date published
- 05/12/2020
- Academic Unit
- Pathology
- Record Identifier
- 9984183987102771
Metrics
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