Pitfalls in machine learning-based assessment of tumor-infiltrating lymphocytes in breast cancer: a report of the International Immuno-Oncology Biomarker Working Group on Breast Cancer
Author(s)
Thagaard, J; Broeckx, G; Page, DB; Jahangir, CA; Verbandt, S; Kos, Z; Gupta, R; Khiroya, R; Abduljabbar, K; Acosta Haab, G; Acs, B; Akturk, G; Almeida, JS; Alvarado-Cabrero, I; Amgad, M; Azmoudeh-Ardalan, F; Badve, S; Baharun, NB; Balslev, E; Bellolio, ER; Bheemaraju, V; Blenman, KRM; Botinelly Mendonca Fujimoto, L; Bouchmaa, N; Burgues, O; Chardas, A; Cheang, MCU; Ciompi, F; Cooper, LAD; Coosemans, A; Corredor, G; Dahl, AB; Dantas Portela, FL; Deman, F; Demaria, S; Dore Hansen, J; Dudgeon, SN; Ebstrup, T; Elghazawy, M; Fernandez-Martin, C; Fox, SB; Gallagher, WM; Giltnane, JM; Gnjatic, S; Gonzalez-Ericsson, PI; Grigoriadis, A; Halama, N; Hanna, MG; Harbhajanka, A; Hart, SN; Hartman, J; Hauberg, S; Hewitt, S; Hida, AI; Horlings, HM; Husain, Z; Hytopoulos, E; Irshad, S; Janssen, EAM; Kahila, M; Kataoka, TR; Kawaguchi, K; Kharidehal, D; Khramtsov, AI; Kiraz, U; Kirtani, P; Kodach, LL; Korski, K; Kovacs, A; Laenkholm, AV; Lang-Schwarz, C; Larsimont, D; Lennerz, JK; Lerousseau, M; Li, X; Ly, A; Madabhushi, A; Maley, SK; Manur Narasimhamurthy, V; Marks, DK; McDonald, ES; Mehrotra, R; Michiels, S; Minhas, FUAA; Mittal, S; Moore, DA; Mushtaq, S; Nighat, H; Papathomas, T; Penault-Llorca, F; Perera, RD; Pinard, CJ; Pinto-Cardenas, JC; Pruneri, G; Pusztai, L; Rahman, A; Rajpoot, NM; Rapoport, BL; Rau, TT; Reis-Filho, JS; Ribeiro, JM; Rimm, D; Roslind, A; Vincent-Salomon, A; Salto-Tellez, M; Saltz, J; Sayed, S; Scott, E; Siziopikou, KP; Sotiriou, C; Stenzinger, A; Sughayer, MA; Sur, D; Fineberg, S; Symmans, F; Tanaka, S; Taxter, T; Tejpar, S; Teuwen, J; Thompson, EA; Tramm, T; Tran, WT; van der Laak, J; van Diest, PJ; Verghese, GE; Viale, G; Vieth, M; Wahab, N; Walter, T; Waumans, Y; Wen, HY; Yang, W; Yuan, Y; Zin, RM; Adams, S; Bartlett, J; Loibl, S; Denkert, C; Savas, P; Loi, S; Salgado, R; Specht Stovgaard, E;
Details
Publication Year 2023-08,Volume 260,Issue #5,Page 498-513
Journal Title
Journal of Pathology
Publication Type
Review
Abstract
The clinical significance of the tumor-immune interaction in breast cancer is now established, and tumor-infiltrating lymphocytes (TILs) have emerged as predictive and prognostic biomarkers for patients with triple-negative (estrogen receptor, progesterone receptor, and HER2-negative) breast cancer and HER2-positive breast cancer. How computational assessments of TILs might complement manual TIL assessment in trial and daily practices is currently debated. Recent efforts to use machine learning (ML) to automatically evaluate TILs have shown promising results. We review state-of-the-art approaches and identify pitfalls and challenges of automated TIL evaluation by studying the root cause of ML discordances in comparison to manual TIL quantification. We categorize our findings into four main topics: (1) technical slide issues, (2) ML and image analysis aspects, (3) data challenges, and (4) validation issues. The main reason for discordant assessments is the inclusion of false-positive areas or cells identified by performance on certain tissue patterns or design choices in the computational implementation. To aid the adoption of ML for TIL assessment, we provide an in-depth discussion of ML and image analysis, including validation issues that need to be considered before reliable computational reporting of TILs can be incorporated into the trial and routine clinical management of patients with triple-negative breast cancer. (c) 2023 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.
Publisher
Wiley
Keywords
Humans; Animals; Lymphocytes, Tumor-Infiltrating; *Triple Negative Breast Neoplasms; *Mammary Neoplasms, Animal; Biomarkers; Machine Learning; deep learning; digital pathology; guidelines; image analysis; pitfalls; prognostic biomarker; triple-negative breast cancer; tumor-infiltrating lymphocytes
Department(s)
Pathology; Laboratory Research; Medical Oncology
PubMed ID
37608772
Open Access at Publisher's Site
https://doi.org/10.1002/path.6155
Terms of Use/Rights Notice
Refer to copyright notice on published article.


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