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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


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.

Type Journal
ISBN 1533-4031 (Electronic) 1072-4109 (Linking)
Authors Hendry, S.; Salgado, R.; Gevaert, T.; Russell, P. A.; John, T.; Thapa, B.; Christie, M.; van de Vijver, K.; Estrada, M. V.; Gonzalez-Ericsson, P. I.; Sanders, M.; Solomon, B.; Solinas, C.; Van den Eynden, Gggm; Allory, Y.; Preusser, M.; Hainfellner, J.; Pruneri, G.; Vingiani, A.; Demaria, S.; Symmans, F.; Nuciforo, P.; Comerma, L.; Thompson, E. A.; Lakhani, S.; Kim, S. R.; Schnitt, S.; Colpaert, C.; Sotiriou, C.; Scherer, S. J.; Ignatiadis, M.; Badve, S.; Pierce, R. H.; Viale, G.; Sirtaine, N.; Penault-Llorca, F.; Sugie, T.; Fineberg, S.; Paik, S.; Srinivasan, A.; Richardson, A.; Wang, Y.; Chmielik, E.; Brock, J.; Johnson, D. B.; Balko, J.; Wienert, S.; Bossuyt, V.; Michiels, S.; Ternes, N.; Burchardi, N.; Luen, S. J.; Savas, P.; Klauschen, F.; Watson, P. H.; Nelson, B. H.; Criscitiello, C.; O'Toole, S.; Larsimont, D.; de Wind, R.; Curigliano, G.; Andre, F.; Lacroix-Triki, M.; van de Vijver, M.; Rojo, F.; Floris, G.; Bedri, S.; Sparano, J.; Rimm, D.; Nielsen, T.; Kos, Z.; Hewitt, S.; Singh, B.; Farshid, G.; Loibl, S.; Allison, K. H.; Tung, N.; Adams, S.; Willard-Gallo, K.; Horlings, H. M.; Gandhi, L.; Moreira, A.; Hirsch, F.; Dieci, M. V.; Urbanowicz, M.; Brcic, I.; Korski, K.; Gaire, F.; Koeppen, H.; Lo, A.; Giltnane, J.; Rebelatto, M. C.; Steele, K. E.; Zha, J.; Emancipator, K.; Juco, J. W.; Denkert, C.; Reis-Filho, J.; Loi, S.; Fox, S. B.
Responsible Garvan Author Prof Sandra O'Toole
Publisher Name Advances in Anatomic Pathology
Published Date 2017-09-30
Published Volume 24
Published Issue 5
Published Pages 235-251
Status Published in-print
DOI 10.1097/PAP.0000000000000162
URL link to publisher's version