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Open Access 01-08-2018 | Editorial

Reproducibility and predictive value of scoring stromal tumour infiltrating lymphocytes in triple-negative breast cancer: a multi-institutional study

Authors: Mark O’Loughlin, Xavier Andreu, Simonetta Bianchi, Ewa Chemielik, Alicia Cordoba, Gábor Cserni, Paulo Figueiredo, Giuseppe Floris, Maria P. Foschini, Päivi Heikkilä, Janina Kulka, Inta Liepniece-Karele, Peter Regitnig, Angelika Reiner, Ales Ryska, Anna Sapino, Aliaa Shalaby, Elisabeth Specht Stovgaard, Cecily Quinn, Elaine M. Walsh, Vicky Zolota, Sharon A. Glynn, Grace Callagy

Published in: Breast Cancer Research and Treatment | Issue 1/2018

Abstract

Background

Several studies have demonstrated a prognostic role for stromal tumour infiltrating lymphocytes (sTILs) in triple-negative breast cancer (TNBC). The reproducibility of scoring sTILs is variable with potentially excellent concordance being achievable using a software tool. We examined agreement between breast pathologists across Europe scoring sTILs on H&E-stained sections without software, an approach that is easily applied in clinical practice. The association between sTILs and response to anthracycline-taxane NACT was also examined.

Methodology

Pathologists from the European Working Group for Breast Screening Pathology scored sTILs in 84 slides from 75 TNBCs using the immune-oncology biomarker working group guidance in two circulations. There were 16 participants in the first and 19 in the second circulation.

Results

Moderate agreement was achieved for absolute sTILs scores (intraclass correlation coefficient (ICC) = 0.683, 95% CI 0.601–0.767, p-value < 0.001). Agreement was less when a 25% threshold was used (ICC 0.509, 95% CI 0.416–0.614, p-value < 0.001) and for lymphocyte predominant breast cancer (LPBC) (ICC 0.504, 95% CI 0.412–0.610, p-value < 0.001). Intra-observer agreement was strong for absolute sTIL values (Spearman ρ = 0.727); fair for sTILs ≥ 25% (κ = 0.53) and for LPBC (κ = 0.49), but poor for sTILs as 10% increments (κ = 0.24). Increasing sTILs was significantly associated with an increased likelihood of a pathological complete response (pCR) on multivariable analysis.

Conclusion

Increasing sTILs in TNBCs improves the likelihood of a pCR. However, inter-observer agreement is such that H&E-based assessment is not sufficiently reproducible for clinical application. Other methodologies should be explored, but may be at the cost of ease of application.

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Title: Reproducibility and predictive value of scoring stromal tumour infiltrating lymphocytes in triple-negative breast cancer: a multi-institutional study
Authors: Mark O’Loughlin
Xavier Andreu
Simonetta Bianchi
Ewa Chemielik
Alicia Cordoba
Gábor Cserni
Paulo Figueiredo
Giuseppe Floris
Maria P. Foschini
Päivi Heikkilä
Janina Kulka
Inta Liepniece-Karele
Peter Regitnig
Angelika Reiner
Ales Ryska
Anna Sapino
Aliaa Shalaby
Elisabeth Specht Stovgaard
Cecily Quinn
Elaine M. Walsh
Vicky Zolota
Sharon A. Glynn
Grace Callagy
Publication date: 01-08-2018
Publisher: Springer US
Published in: Breast Cancer Research and Treatment / Issue 1/2018
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-018-4825-8

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Background

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