Stromal TIL are a well-recognized prognostic and predictive biomarker in breast cancer. There is a need for tools assisting visual assessment of TIL, to improve reproducibility as well as for convenience. This study aims to assess the clinical significance of AI-powered spatial TIL analysis in the prediction of pathologic complete response (pCR) after NAC in TNBC patients.
H&E stained slides and clinical outcomes data were obtained from stage I – III TNBC patients treated with NAC in two centers in Korea. For spatial TIL analysis, we used Lunit SCOPE IO, an AI-powered H&E Whole-Slide Image (WSI) analyzer, which identifies and quantifies TIL within the cancer or stroma area. Lunit SCOPE IO was developed with a 13.5 x 109 micrometer2 area and 6.2 x 106 TIL from 17,849 H&E WSI of multiple cancer types, annotated by 104 board-certified pathologists. iTIL score and sTIL score were defined as area occupied by TIL in the intratumoral area (%) and the surrounding stroma (%), respectively. Immune phenotype (IP) of each slide was defined from spatial TIL calculation, as inflamed (high TIL density in tumor area), immune-excluded (high TIL density in stroma), or desert (low TIL density overall).
A total of 954 TNBC patients treated from 2006 to 2019 were included in this analysis. pCR (ypT0N0) was confirmed in 261 (27.4%) patients. The neoadjuvant regimens used were mostly anthracycline (97.8%) and taxane (75.1%) -based, with 116 (12.1%) patients receiving additional platinum and 41 (4.3%) patients treated as part of immune checkpoint inhibitor or PARP inhibitor clinical trials.
The median iTIL score and sTIL score were 4.3% (IQR 3.2 – 5.8) and 8.1% (IQR 6.3 – 13.4), respectively. The mean iTIL score was significantly higher in patients who achieved pCR after NAC (5.8% vs. 4.5%, p < 0.001), and a similar difference was observed with sTIL score (12.1%.1 vs. 9.4%, p < 0.001). iTIL score was found to remain as an independent predictor of pCR along with cT stage and Ki-67 in the multivariable analysis (adjusted odds ratio 1.211 (95% CI 1.125 - 1.304) per 1 point (%) change in the score, p <0.001). By IP groups, 291 (30.5%) patients were classified as inflamed, 502 (52.6%) as excluded, and 161 (16.9%) as desert phenotype. The patients with inflamed phenotype were more likely to achieve pCR (44.7%) than other phenotypes (19.8%, p < 0.001).
AI-powered spatial TIL analysis could assess TIL densities in the cancer area and surrounding stroma of TNBC, and TIL density scores and IP classification could predict pCR after NAC.
Hee Jin Lee1, Gyungyub Gong1, Soo Youn Cho2, Eun Yoon Cho2, Yoojoo Lim3, Soo Ick Cho3, Wonkyung Jung3, Sanghoon Song3, Mingu Kang3, Jeongun Ryu3, Minuk Ma3, Seonwook Park3, Kyunghyun Paeng3, Chan-Young Ock3, Sang Yong Song2.
1Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea.
2Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea. 3Lunit Inc., Seoul, Republic of Korea
Abstract: Deep learning-based predictive biomarker for adjuvant chemotherapy in early-stage hormone receptor-positive breast cancer
Abstract: Pan-cancer analysis of tumor microenvironment using deep learning-based cancer stroma and immune profiling in H&E images
Abstract: Deep learning-based predictive biomarker for immune checkpoint inhibitor response in metastatic non-small cell lung cancer
Abstract: Comprehensive deep learning analysis of H&E tissue phenomics reveals distinct immune landscape and transcriptomic enrichment profile among immune inflamed, excluded and desert subtypes...
Abstract: Deep-learning analysis of H&E images to define three immune phenotypes to reveal loss-of-target in excluded immune cells as a novel resistance mechanism of immune checkpoint inhibitor...
Abstract: Deep learning-based immune phenotype analysis reveals distinct resistance pattern of immune checkpoint inhibitor in non-small cell lung cancer
Reducing Domain Gap by Reducing Style Bias
Predicting breast tumor proliferation from whole-slide images: The TUPAC16 challenge
Accuracy and efficiency of an artificial intelligence tool when counting breast mitoses
Abstract: Artificial intelligence-powered spatial analysis of tumor infiltrating lymphocytes (TIL) to reflect target gene expressions of novel immuno-oncology agents.
Abstract: Distinct subset of immune cells assessed by multiplex immunohistochemistry correlates with immune phenotype classified by ...
Abstract : Pathologic validation of artificial intelligence-powered prediction of combined positive score of PD-L1 immunohistochemistry in urothelial carcinoma.
Abstract : Clinical performance of artificial intelligence-powered annotation of tumor cell PD-L1 expression for treatment of immune-checkpoint inhibitor (ICI) ...
Abstract : Artificial intelligence-powered spatial analysis of tumor-infiltrating lymphocytes predicts survival after immune checkpoint inhibitor therapy across multiple cancer types.
Abstract : Deep learning based radiomic biomarker for predicting the presence of high-grade histologic patterns in lung adenocarcinoma
Abstract : Artificial intelligence-powered tissue analysis reveals distinct tumor-infiltrating lymphocyte profile as a potential biomarker of molecular subtypes in endometrial cancer
Abstract : Artificial intelligence-powered spatial analysis of tumor-infiltrating lymphocytes reveals distinct genomic profile of immune excluded phenotype in pan-carcinoma
Deep learning from HE slides predicts the clinical benefit from adjuvant chemotherapy in hormone receptor-positive breast cancer patients
Abstract : Interim results of phase I dose escalation study of YBL-006: A novel anti-PD-1 monoclonal antibody in advanced solid tumors
Abstract : Assistance with an artificial intelligence-powered PD-L1 analyzer reduces interobserver variation in pathologic reading of tumor proportion score in non-small cell lung cancer
Abstract : AI-powered whole-slide image analysis of tumor-infiltrating lymphocytes for prediction of prognosis in colorectal cancer
Deep Learning Analysis of CT Images Reveals High-Grade Pathological Features to Predict Survival in Lung Adenocarcinoma
Artificial Intelligence–Powered Spatial Analysis of Tumor-Infiltrating Lymphocytes as Complementary Biomarker for Immune Checkpoint Inhibition in Non–Small-Cell Lung Cancer
Artificial Intelligence–Powered Hematoxylin and Eosin Analyzer Reveals Distinct Immunologic and Mutational Profiles among Immune Phenotypes in Non–Small-Cell Lung Cancer
Abstract : Artificial Intelligence-Powered Analyzer Reduces Inter-observer Variation in PD-L1 Tumor Proportion Score of Non-Small Cell Lung Cancer
Abstract : Artificial Intelligence-Powered Tumor Purity Assessment From H&E Whole Slide Images Correlates...
Abstract : Deep learning-based H&E analyzer reveals distinct immune profiles and clinical outcomes among immune phenotypes in uterine corpus endometrial carcinoma
Abstract : Artificial intelligence-powered spatial analysis of tumor-infiltrating lymphocytes reveals immune-excluded phenotype is correlated with TGF-beta pathway related genomic aberrations
Observer Performance Study to Examine the Feasibility of the AI-powered PD-L1 Analyzer to Assist Pathologists’ Assessment of PD-L1 Expression Using Tumor Proportion Score in Non-Small Cell Lung Cancer
Artificial intelligence-powered human epidermal growth factor receptor 2 (HER2) analyzer in breast cancer as an assistance tool for pathologists to reduce interobserver variation
Artificial intelligence-powered whole-slide image analyzer reveals a distinctive distribution of tumor-infiltrating lymphocytes in neuroendocrine tumors and carcinomas
Artificial intelligence (AI)-powered pathology image analysis merged with spatial transcriptomics reveals distinct TIGIT expression in the immune-excluded tumor-infiltrating lymphocytes
Trastuzumab plus FOLFOX for Gemcitabine/Cisplatin refractory HER2-positive biliary tract cancer: a multi-institutional phase II trial of the Korean Cancer Study Group (KCSG-HB19-14)
The Inflamed Immune Phenotype (IIP): a clinically actionable artificial intelligence (AI)-based biomarker predictive of immune checkpoint inhibitor (ICI) outcomes across >16 primary tumor types
Safety and efficacy of YBL-006, an anti-PD-1 monoclonal antibody in advanced solid tumors: a phase I study
Robust artificial intelligence-powered imaging biomarker based on mammography for risk prediction of breast cancer.