Pitfalls in assessing stromal tumor infiltrating lymphocytes (sTILs) in breast cancer.
Date
2020-05-12Author
Kos, Z
Roblin, E
Kim, RS
Michiels, S
Gallas, BD
Chen, W
van de Vijver, KK
Goel, S
Adams, S
Demaria, S
Viale, G
Nielsen, TO
Badve, SS
Symmans, WF
Sotiriou, C
Rimm, DL
Hewitt, S
Denkert, C
Loibl, S
Luen, SJ
Bartlett, JMS
Savas, P
Pruneri, G
Dillon, DA
Cheang, MCU
Tutt, A
Hall, JA
Kok, M
Horlings, HM
Madabhushi, A
van der Laak, J
Ciompi, F
Laenkholm, A-V
Bellolio, E
Gruosso, T
Fox, SB
Araya, JC
Floris, G
Hudeček, J
Voorwerk, L
Beck, AH
Kerner, J
Larsimont, D
Declercq, S
Van den Eynden, G
Pusztai, L
Ehinger, A
Yang, W
AbdulJabbar, K
Yuan, Y
Singh, R
Hiley, C
Bakir, MA
Lazar, AJ
Naber, S
Wienert, S
Castillo, M
Curigliano, G
Dieci, M-V
André, F
Swanton, C
Reis-Filho, J
Sparano, J
Balslev, E
Chen, I-C
Stovgaard, EIS
Pogue-Geile, K
Blenman, KRM
Penault-Llorca, F
Schnitt, S
Lakhani, SR
Vincent-Salomon, A
Rojo, F
Braybrooke, JP
Hanna, MG
Soler-Monsó, MT
Bethmann, D
Castaneda, CA
Willard-Gallo, K
Sharma, A
Lien, H-C
Fineberg, S
Thagaard, J
Comerma, L
Gonzalez-Ericsson, P
Brogi, E
Loi, S
Saltz, J
Klaushen, F
Cooper, L
Amgad, M
Moore, DA
Salgado, R
International Immuno-Oncology Biomarker Working Group,
Type
Journal Article
Metadata
Show full item recordAbstract
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.
Collections
Subject
International Immuno-Oncology Biomarker Working Group
Research team
Genomic Analysis – Clinical Trials
Language
eng
Date accepted
2020-03-02
License start date
2020-01
Citation
NPJ breast cancer, 2020, 6 pp. 17 - ?
Publisher
NATURE RESEARCH