Interobserver variability in the assessment of stromal tumor-infiltrating lymphocytes (sTILs) in triple-negative invasive breast carcinoma influences the association with pathological complete response: the IVITA study.

Détails

ID Serval
serval:BIB_ABAAD9677C23
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Institution
Titre
Interobserver variability in the assessment of stromal tumor-infiltrating lymphocytes (sTILs) in triple-negative invasive breast carcinoma influences the association with pathological complete response: the IVITA study.
Périodique
Modern pathology
Auteur⸱e⸱s
Van Bockstal M.R., François A., Altinay S., Arnould L., Balkenhol M., Broeckx G., Burguès O., Colpaert C., Dedeurwaerdere F., Dessauvagie B., Duwel V., Floris G., Fox S., Gerosa C., Hastir D., Jaffer S., Kurpershoek E., Lacroix-Triki M., Laka A., Lambein K., MacGrogan G.M., Marchiò C., Martin Martinez M.D., Nofech-Mozes S., Peeters D., Ravarino A., Reisenbichler E., Resetkova E., Sanati S., Schelfhout A.M., Schelfhout V., Shaaban A., Sinke R., Stanciu-Pop C.M., van Deurzen CHM, Van de Vijver K.K., Van Rompuy A.S., Vincent-Salomon A., Wen H.Y., Wong S., Bouzin C., Galant C.
ISSN
1530-0285 (Electronic)
ISSN-L
0893-3952
Statut éditorial
Publié
Date de publication
12/2021
Peer-reviewed
Oui
Volume
34
Numéro
12
Pages
2130-2140
Langue
anglais
Notes
Publication types: Journal Article ; Multicenter Study ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Résumé
High stromal tumor-infiltrating lymphocytes (sTILs) in triple-negative breast cancer (TNBC) are associated with pathological complete response (pCR) after neoadjuvant chemotherapy (NAC). Histopathological assessment of sTILs in TNBC biopsies is characterized by substantial interobserver variability, but it is unknown whether this affects its association with pCR. Here, we aimed to investigate the degree of interobserver variability in an international study, and its impact on the relationship between sTILs and pCR. Forty pathologists assessed sTILs as a percentage in digitalized biopsy slides, originating from 41 TNBC patients who were treated with NAC followed by surgery. Pathological response was quantified by the MD Anderson Residual Cancer Burden (RCB) score. Intraclass correlation coefficients (ICCs) were calculated per pathologist duo and Bland-Altman plots were constructed. The relation between sTILs and pCR or RCB class was investigated. The ICCs ranged from -0.376 to 0.947 (mean: 0.659), indicating substantial interobserver variability. Nevertheless, high sTILs scores were significantly associated with pCR for 36 participants (90%), and with RCB class for eight participants (20%). Post hoc sTILs cutoffs at 20% and 40% resulted in variable associations with pCR. The sTILs in TNBC with RCB-II and RCB-III were intermediate to those of RCB-0 and RCB-I, with lowest sTILs observed in RCB-I. However, the limited number of RCB-I cases precludes any definite conclusions due to lack of power, and this observation therefore requires further investigation. In conclusion, sTILs are a robust marker for pCR at the group level. However, if sTILs are to be used to guide the NAC scheme for individual patients, the observed interobserver variability might substantially affect the chance of obtaining a pCR. Future studies should determine the 'ideal' sTILs threshold, and attempt to fine-tune the patient selection for sTILs-based de-escalation of NAC regimens. At present, there is insufficient evidence for robust and reproducible sTILs-guided therapeutic decisions.
Mots-clé
Adult, Aged, Aged, 80 and over, Australia, Chemotherapy, Adjuvant, Clinical Decision-Making, Europe, Female, Humans, Lymphocytes, Tumor-Infiltrating/drug effects, Lymphocytes, Tumor-Infiltrating/immunology, Lymphocytes, Tumor-Infiltrating/pathology, Mastectomy, Middle Aged, Neoadjuvant Therapy, Neoplasm Invasiveness, North America, Observer Variation, Predictive Value of Tests, Reproducibility of Results, Stromal Cells/drug effects, Stromal Cells/immunology, Stromal Cells/pathology, Treatment Outcome, Triple Negative Breast Neoplasms/immunology, Triple Negative Breast Neoplasms/pathology, Triple Negative Breast Neoplasms/therapy, Tumor Microenvironment/immunology
Pubmed
Web of science
Création de la notice
05/07/2021 14:12
Dernière modification de la notice
16/09/2023 6:54
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