Strategies for clinical implementation of TNM-Immunoscore in resected nonsmall-cell lung cancer

T Donnem; T K Kilvaer; S Andersen; E Richardsen; E E Paulsen; S M Hald; S Al-Saad; O T Brustugun; A Helland; M Lund-Iversen; S Solberg; B H Gronberg; S G F Wahl; L Helgeland; O Fløtten; M Pohl; K Al-Shibli; T M Sandanger; F Pezzella; L T Busund; R M Bremnes

doi:10.1093/annonc/mdv560

Strategies for clinical implementation of TNM-Immunoscore in resected nonsmall-cell lung cancer

Ann Oncol. 2016 Feb;27(2):225-32. doi: 10.1093/annonc/mdv560. Epub 2015 Nov 16.

Authors

T Donnem¹, T K Kilvaer², S Andersen², E Richardsen³, E E Paulsen⁴, S M Hald⁵, S Al-Saad³, O T Brustugun⁶, A Helland⁷, M Lund-Iversen⁸, S Solberg⁹, B H Gronberg¹⁰, S G F Wahl¹¹, L Helgeland¹², O Fløtten¹³, M Pohl¹⁴, K Al-Shibli¹⁵, T M Sandanger¹⁶, F Pezzella¹⁷, L T Busund³, R M Bremnes⁴

Affiliations

¹ Department of Oncology, University Hospital of North Norway, Tromso Institute of Clinical Medicine, The Arctic University of Norway, Tromso tom.donnem@uit.no.
² Department of Oncology, University Hospital of North Norway, Tromso.
³ Department of Clinical Pathology, University Hospital of North Norway, Tromso Institute of Medical Biology, The Arctic University of Norway, Tromso.
⁴ Department of Oncology, University Hospital of North Norway, Tromso Institute of Clinical Medicine, The Arctic University of Norway, Tromso.
⁵ Institute of Clinical Medicine, The Arctic University of Norway, Tromso.
⁶ Department of Oncology, Oslo University Hospital, The Norwegian Radium Hospital, Oslo.
⁷ Department of Oncology, Oslo University Hospital, The Norwegian Radium Hospital, Oslo Department of Cancer Genetics, Oslo University Hospital, The Norwegian Radium Hospital, Oslo.
⁸ Department of Pathology, Oslo University Hospital, The Norwegian Radium Hospital, Oslo.
⁹ Department of Cardiothoracic Surgery, Oslo University Hospital, Rikshospitalet, Oslo.
¹⁰ The Cancer Clinic, St Olavs Hospital, Trondheim University Hospital, Trondheim Department of Cancer Research and Molecular Medicine, European Palliative Care Research Centre, Norwegian University of Science and Technology, Trondheim.
¹¹ Department of Pathology and Medical Genetics, St Olavs Hospital-Trondheim University Hospital, Trondheim.
¹² Department of Pathology, Haukeland University Hospital, Bergen, Norway.
¹³ Department of Thoracic Medicine, Haukeland University Hospital, Bergen, Norway.
¹⁴ Department of Oncology, Rigshospitalet, Copenhagen, Denmark.
¹⁵ Department of Pathology, Nordland Hospital, Bodo.
¹⁶ Department of Community Medicine, The Artic University of Tromso, Tromso, Norway.
¹⁷ Nuffield Department of Clinical Laboratory Sciences, University of Oxford, John Radcliffe Hospital, Oxford, UK.

PMID: 26578726
DOI: 10.1093/annonc/mdv560

Abstract

Immunoscore is a prognostic tool defined to quantify in situ immune cell infiltrates and appears highly promising as a supplement to the tumor-node-metastasis (TNM) classification of various tumors. In colorectal cancer, an international task force has initiated prospective multicenter studies aiming to implement TNM-Immunoscore (TNM-I) in a routine clinical setting. In breast cancer, recommendations for the evaluation of tumor-infiltrating lymphocytes (TILs) have been proposed by an international working group. Regardless of promising results, there are potential obstacles related to implementing TNM-I into the clinic. Diverse methods may be needed for different malignancies and even within each cancer entity. Nevertheless, a uniform approach across malignancies would be advantageous. In nonsmall-cell lung cancer (NSCLC), there are several previous reports indicating an apparent prognostic importance of TILs, but studies on TILs in a TNM-I setting are sparse and no general recommendations are made. However, recently published data is promising, evoking a realistic hope of a clinical useful NSCLC TNM-I. This review will focus on the TNM-I potential in NSCLC and propose strategies for clinical implementation of a TNM-I in resected NSCLC.

Keywords: NSCLC; T cells; TNM-I; immunoscore; lung cancer.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Carcinoma, Non-Small-Cell Lung / diagnosis
Carcinoma, Non-Small-Cell Lung / mortality
Carcinoma, Non-Small-Cell Lung / pathology*
Humans
Lung Neoplasms / diagnosis
Lung Neoplasms / mortality
Lung Neoplasms / pathology*
Lymphocytes, Tumor-Infiltrating / immunology
Lymphocytes, Tumor-Infiltrating / pathology*
Neoplasm Metastasis / diagnosis
Neoplasm Metastasis / pathology
Neoplasm Staging
Prognosis
Severity of Illness Index
Tumor Microenvironment / immunology