Assessing Tumor-infiltrating Lymphocytes in Solid Tumors: A Practical Review for Pathologists and Proposal for a Standardized Method from the International Immunooncology Biomarkers Working Group: Part 1: Assessing the Host Immune Response, TILs in Invasive Breast Carcinoma and Ductal Carcinoma in Situ, Metastatic Tumor Deposits and Areas for Further Research

Shona Hendry, Roberto Salgado, Thomas Gevaert, Prudence A. Russell, Tom John, Bibhusal Thapa, Michael Christie, Koen Van De Vijver, M. V. Estrada, Paula I. Gonzalez-Ericsson, Melinda Sanders, Benjamin Solomon, Cinzia Solinas, Gert G.G.M. Van Den Eynden, Yves Allory, Matthias Preusser, Johannes Hainfellner, Giancarlo Pruneri, Andrea Vingiani, Sandra DemariaFraser Symmans, Paolo Nuciforo, Laura Comerma, E. A. Thompson, Sunil Lakhani, Seong Rim Kim, Stuart Schnitt, Cecile Colpaert, Christos Sotiriou, Stefan J. Scherer, Michail Ignatiadis, Sunil Badve, Robert H. Pierce, Giuseppe Viale, Nicolas Sirtaine, Frederique Penault-Llorca, Tomohagu Sugie, Susan Fineberg, Soonmyung Paik, Ashok Srinivasan, Andrea Richardson, Yihong Wang, Ewa Chmielik, Jane Brock, Douglas B. Johnson, Justin Balko, Stephan Wienert, Veerle Bossuyt, Stefan Michiels, Nils Ternes, Nicole Burchardi, Stephen J. Luen, Peter Savas, Frederick Klauschen, Peter H. Watson, Brad H. Nelson, Carmen Criscitiello, Sandra O'Toole, Denis Larsimont, Roland De Wind, Giuseppe Curigliano, Fabrice André, Magali Lacroix-Triki, Mark Van De Vijver, Federico Rojo, Giuseppe Floris, Shahinaz Bedri, Joseph Sparano, David Rimm, Torsten Nielsen, Zuzana Kos, Stephen Hewitt, Baljit Singh, Gelareh Farshid, Sibylle Loibl, Kimberly H. Allison, Nadine Tung, Sylvia Adams, Karen Willard-Gallo, Hugo M. Horlings, Leena Gandhi, Andre Moreira, Fred Hirsch, Maria V. Dieci, Maria Urbanowicz, Iva Brcic, Konstanty Korski, Fabien Gaire, Hartmut Koeppen, Amy Lo, Jennifer Giltnane, Marlon C. Rebelatto, Keith E. Steele, Jiping Zha, Kenneth Emancipator, Jonathan W. Juco, Carsten Denkert, Jorge Reis-Filho, Sherene Loi, Stephen B. Fox

Research output: Contribution to journalReview articlepeer-review

436 Scopus citations

Abstract

Assessment of tumor-infiltrating lymphocytes (TILs) in histopathologic specimens can provide important prognostic information in diverse solid tumor types, and may also be of value in predicting response to treatments. However, implementation as a routine clinical biomarker has not yet been achieved. As successful use of immune checkpoint inhibitors and other forms of immunotherapy become a clinical reality, the need for widely applicable, accessible, and reliable immunooncology biomarkers is clear. In part 1 of this review we briefly discuss the host immune response to tumors and different approaches to TIL assessment. We propose a standardized methodology to assess TILs in solid tumors on hematoxylin and eosin sections, in both primary and metastatic settings, based on the International Immuno-Oncology Biomarker Working Group guidelines for TIL assessment in invasive breast carcinoma. A review of the literature regarding the value of TIL assessment in different solid tumor types follows in part 2. The method we propose is reproducible, affordable, easily applied, and has demonstrated prognostic and predictive significance in invasive breast carcinoma. This standardized methodology may be used as a reference against which other methods are compared, and should be evaluated for clinical validity and utility. Standardization of TIL assessment will help to improve consistency and reproducibility in this field, enrich both the quality and quantity of comparable evidence, and help to thoroughly evaluate the utility of TILs assessment in this era of immunotherapy.

Original languageEnglish (US)
Pages (from-to)235-251
Number of pages17
JournalAdvances in Anatomic Pathology
Volume24
Issue number5
DOIs
StatePublished - 2017

Keywords

  • biomarkers
  • cancer
  • immunotherapy
  • lymphocytes
  • pathology
  • tumor-infiltrating

ASJC Scopus subject areas

  • Anatomy
  • Pathology and Forensic Medicine

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