2
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Dercle L, Ammari S, Roblin E, Bigorgne A, Champiat S, Taihi L, Plaian A, Hans S, Lakiss S, Tselikas L, Rouanne M, Deutsch E, Schwartz LH, Gönen M, Flynn J, Massard C, Soria JC, Robert C, Marabelle A. High serum LDH and liver metastases are the dominant predictors of primary cancer resistance to anti-PD(L)1 immunotherapy. Eur J Cancer 2022; 177:80-93. [PMID: 36332438 DOI: 10.1016/j.ejca.2022.08.034] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 08/27/2022] [Indexed: 01/06/2023]
Abstract
AIM Anti-PD-(L)1 immunotherapies improve survival in multiple cancers but remain ineffective for most patients. We applied machine-learning algorithms and multivariate analyses on baseline medical data to estimate their relative impact on overall survival (OS) upon anti-PD-(L)1 monotherapies. METHOD This prognostic/predictive study retrospectively analysed 33 baseline routine medical variables derived from computed tomography (CT) images, clinical and biological meta-data. 695 patients with a diagnosis of advanced cancer were treated in prospective clinical trials in a single tertiary cancer centre in 3 cohorts including systemic anti-PD-(L)1 (251, 235 patients) versus other systemic therapies (209 patients). A random forest model combined variables to identify the combination (signature) which best estimated OS in patients treated with immunotherapy. The performance for estimating OS [95%CI] was measured using Kaplan-Meier Analysis and Log-Rank test. RESULTS Elevated serum lactate dehydrogenase (LDHhi) and presence of liver metastases (LM+) were dominant and independent predictors of short OS in independent cohorts of melanoma and non-melanoma solid tumours. Overall, LDHhiLM+ patients treated with anti-PD-(L)1 monotherapy had a poorer outcome (median OS: 3.1[2.4-7.8] months]) compared to LDHlowLM-patients (median OS: 15.3[8.9-NA] months; P < 0.0001). The OS of LDHlowLM-patients treated with immunotherapy was 28.8[17.9-NA] months (vs 13.1[10.8-18.5], P = 0.02) in the overall population and 30.3[19.93-NA] months (vs 14.1[8.69-NA], P = 0.0013) in patients with melanoma. CONCLUSION LDHhiLM+ status identifies patients who shall not benefit from anti-PD-(L)1 monotherapy. It could be used in clinical trials to stratify patients and eventually address this specific medical need.
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Affiliation(s)
- Laurent Dercle
- INSERM U1015 & CIC1428, Gustave Roussy, 94805 Villejuif, France.
| | - Samy Ammari
- Département de Radiologie, Gustave Roussy, 94805 Villejuif, France; BIOMAPS. UMR1281 INSERM. CEA. CNRS.Université Paris-Saclay, Villejuif, France
| | - Elvire Roblin
- Service de Biostatistique et D'Épidémiologie, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Oncostat U1018, INSERM, Université Paris-Saclay, Équipe Labellisée Ligue Contre le Cancer, Villejuif, France
| | - Amelie Bigorgne
- INSERM U1015 & CIC1428, Gustave Roussy, 94805 Villejuif, France; INSERM U1163, Institut Imagine, Paris, France
| | | | - Lokmane Taihi
- Département de Radiologie, Gustave Roussy, 94805 Villejuif, France
| | - Athèna Plaian
- Département de Radiologie, Gustave Roussy, 94805 Villejuif, France
| | - Sophie Hans
- Département de Radiologie, Gustave Roussy, 94805 Villejuif, France
| | - Sara Lakiss
- Département de Radiologie, Gustave Roussy, 94805 Villejuif, France
| | | | - Mathieu Rouanne
- Hôpital Foch, UVSQ-Université Paris-Saclay, Suresnes, France; Departement D'Innovation Thérapeutique et des Essais Précoces (DITEP), Gustave Roussy, Universite Paris Saclay, Villejuif, France
| | - Eric Deutsch
- Departement de Radiothérapie, Gustave Roussy, Université Paris Saclay, 94805 Villejuif, France
| | - Lawrence H Schwartz
- Department of Radiology, NewYork-Presbyterian, Columbia University Irving Medical Center, NY, USA
| | - Mithat Gönen
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jessica Flynn
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Christophe Massard
- Departement D'Innovation Thérapeutique et des Essais Précoces (DITEP), Gustave Roussy, Universite Paris Saclay, Villejuif, France
| | - Jean-Charles Soria
- Departement D'Innovation Thérapeutique et des Essais Précoces (DITEP), Gustave Roussy, Universite Paris Saclay, Villejuif, France; INSERM U981, Gustave Roussy, Villejuif, France
| | - Caroline Robert
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Departement de Médecine Oncologique, Gustave Roussy, Université Paris Saclay, Villejuif, France
| | - Aurélien Marabelle
- INSERM U1015 & CIC1428, Gustave Roussy, 94805 Villejuif, France; Departement D'Innovation Thérapeutique et des Essais Précoces (DITEP), Gustave Roussy, Universite Paris Saclay, Villejuif, France.
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4
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Kos Z, Roblin E, Kim RS, Michiels S, Gallas BD, Chen W, van de Vijver KK, Goel S, Adams S, Demaria S, Viale G, Nielsen TO, Badve SS, Symmans WF, Sotiriou C, Rimm DL, Hewitt S, Denkert C, Loibl S, Luen SJ, Bartlett JMS, Savas P, Pruneri G, Dillon DA, Cheang MCU, Tutt A, Hall JA, Kok M, Horlings HM, Madabhushi A, van der Laak J, Ciompi F, Laenkholm AV, Bellolio E, Gruosso T, Fox SB, Araya JC, Floris G, Hudeček J, Voorwerk L, Beck AH, Kerner J, Larsimont D, Declercq S, Van den Eynden G, Pusztai L, Ehinger A, Yang W, AbdulJabbar K, Yuan Y, Singh R, Hiley C, Bakir MA, Lazar AJ, Naber S, Wienert S, Castillo M, Curigliano G, Dieci MV, André F, Swanton C, Reis-Filho J, Sparano J, Balslev E, Chen IC, Stovgaard EIS, Pogue-Geile K, Blenman KRM, Penault-Llorca F, Schnitt S, Lakhani SR, Vincent-Salomon A, Rojo F, Braybrooke JP, Hanna MG, Soler-Monsó MT, Bethmann D, Castaneda CA, Willard-Gallo K, Sharma A, Lien HC, Fineberg S, Thagaard J, Comerma L, Gonzalez-Ericsson P, Brogi E, Loi S, Saltz J, Klaushen F, Cooper L, Amgad M, Moore DA, Salgado R. Pitfalls in assessing stromal tumor infiltrating lymphocytes (sTILs) in breast cancer. NPJ Breast Cancer 2020; 6:17. [PMID: 32411819 PMCID: PMC7217863 DOI: 10.1038/s41523-020-0156-0] [Citation(s) in RCA: 89] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Accepted: 03/02/2020] [Indexed: 02/08/2023] Open
Abstract
Stromal tumor-infiltrating lymphocytes (sTILs) are important prognostic and predictive biomarkers in triple-negative (TNBC) and HER2-positive breast cancer. Incorporating sTILs into clinical practice necessitates reproducible assessment. Previously developed standardized scoring guidelines have been widely embraced by the clinical and research communities. We evaluated sources of variability in sTIL assessment by pathologists in three previous sTIL ring studies. We identify common challenges and evaluate impact of discrepancies on outcome estimates in early TNBC using a newly-developed prognostic tool. Discordant sTIL assessment is driven by heterogeneity in lymphocyte distribution. Additional factors include: technical slide-related issues; scoring outside the tumor boundary; tumors with minimal assessable stroma; including lymphocytes associated with other structures; and including other inflammatory cells. Small variations in sTIL assessment modestly alter risk estimation in early TNBC but have the potential to affect treatment selection if cutpoints are employed. Scoring and averaging multiple areas, as well as use of reference images, improve consistency of sTIL evaluation. Moreover, to assist in avoiding the pitfalls identified in this analysis, we developed an educational resource available at www.tilsinbreastcancer.org/pitfalls.
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Affiliation(s)
- Zuzana Kos
- Department of Pathology, BC Cancer - Vancouver, Vancouver, BC Canada
| | - Elvire Roblin
- Department of Biostatistics and Epidemiology, Gustave Roussy, University Paris-Saclay, Villejuif, France
- Oncostat U1018, Inserm, University Paris-Saclay, labeled Ligue Contre le Cancer, Villejuif, France
| | - Rim S. Kim
- National Surgical Adjuvant Breast and Bowel Project (NSABP)/NRG Oncology, Pittsburgh, PA USA
| | - Stefan Michiels
- Department of Biostatistics and Epidemiology, Gustave Roussy, University Paris-Saclay, Villejuif, France
- Oncostat U1018, Inserm, University Paris-Saclay, labeled Ligue Contre le Cancer, Villejuif, France
| | - Brandon D. Gallas
- Division of Imaging, Diagnostics, and Software Reliability (DIDSR); Office of Science and Engineering Laboratories (OSEL); Center for Devices and Radiological Health (CDRH), US Food and Drug Administration (US FDA), Silver Spring, MD USA
| | - Weijie Chen
- Division of Imaging, Diagnostics, and Software Reliability (DIDSR); Office of Science and Engineering Laboratories (OSEL); Center for Devices and Radiological Health (CDRH), US Food and Drug Administration (US FDA), Silver Spring, MD USA
| | - Koen K. van de Vijver
- Department of Pathology, University Hospital Antwerp, Antwerp, Belgium
- Department of Pathology, Ghent University Hospital, Cancer Research Institute Ghent (CRIG), Ghent, Belgium
| | - Shom Goel
- The Sir Peter MacCallum Cancer Centre, Melbourne, VIC Australia
- Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria Australia
| | - Sylvia Adams
- Perlmutter Cancer Center, New York University Medical School, New York, NY USA
| | - Sandra Demaria
- Departments of Radiation Oncology and Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY USA
| | - Giuseppe Viale
- Department of Pathology, Istituto Europeo di Oncologia, University of Milan, Milan, Italy
| | - Torsten O. Nielsen
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - Sunil S. Badve
- Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, USA
| | - W. Fraser Symmans
- Department of Pathology, The University of Texas M.D. Anderson Cancer Center, Houston, TX USA
| | - Christos Sotiriou
- Department of Medical Oncology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - David L. Rimm
- Department of Pathology, Yale School of Medicine, New Haven, CT USA
| | - Stephen Hewitt
- Laboratory of Pathology, National Cancer Institute, NIH, Bethesda, MD USA
| | - Carsten Denkert
- Institute of Pathology, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg and Philipps-Universität Marburg, Marburg, Germany
| | | | - Stephen J. Luen
- Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria Australia
- Division of Research and Cancer Medicine, Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, VIC Australia
| | - John M. S. Bartlett
- Ontario Institute for Cancer Research, Toronto, ON Canada
- University of Edinburgh Cancer Research Centre, Edinburgh, UK
| | - Peter Savas
- Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria Australia
- Division of Research and Cancer Medicine, Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, VIC Australia
| | - Giancarlo Pruneri
- Department of Pathology, IRCCS Fondazione Instituto Nazionale Tumori and University of Milan, School of Medicine, Milan, Italy
| | - Deborah A. Dillon
- Department of Pathology, Brigham and Women’s Hospital, Boston, MA USA
- Department of Pathology, Dana Farber Cancer Institute, Boston, MA USA
| | - Maggie Chon U. Cheang
- Institute of Cancer Research Clinical Trials and Statistics Unit, The Institute of Cancer Research, Surrey, UK
| | - Andrew Tutt
- Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK
| | | | - Marleen Kok
- Department of Medical Oncology and Division of Tumor Biology & Immunology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Hugo M. Horlings
- Department of Pathology, University Hospital Antwerp, Antwerp, Belgium
- Division of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Anant Madabhushi
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH USA
- Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH USA
| | - Jeroen van der Laak
- Computational Pathology Group, Department of Pathology, Radboud University Medical Center, Nijmegen, Netherlands
| | - Francesco Ciompi
- Computational Pathology Group, Department of Pathology, Radboud University Medical Center, Nijmegen, Netherlands
| | | | - Enrique Bellolio
- Departamento de Anatomía Patológica, Universidad de La Frontera, Temuco, Chile
| | | | - Stephen B. Fox
- The Sir Peter MacCallum Cancer Centre, Melbourne, VIC Australia
- Department of Pathology, Peter MacCallum Cancer Centre Department of Pathology, Melbourne, VIC Australia
| | | | - Giuseppe Floris
- KU Leuven- Univerisity of Leuven, Department of Imaging and Pathology, Laboratory of Translational Cell & Tissue Research and KU Leuven- University Hospitals Leuven, Department of Pathology, Leuven, Belgium
| | - Jan Hudeček
- Department of Research IT, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Leonie Voorwerk
- Division of Tumor Biology & Immunology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | | | | | - Denis Larsimont
- Department of Pathology, Jules Bordet Institute, Brussels, Belgium
| | | | | | - Lajos Pusztai
- Department of Internal Medicine, Section of Medical Oncology, Yale Cancer Center, Yale School of Medicine, New Haven, CT USA
| | - Anna Ehinger
- Department of Clinical Genetics and Pathology, Skåne University Hospital, Lund University, Lund, Sweden
| | - Wentao Yang
- Department of Pathology, Fudan University Shanghai Cancer Centre, Shanghai, China
| | - Khalid AbdulJabbar
- Centre for Evolution and Cancer; Division of Molecular Pathology, The Institute of Cancer Research, London, UK
| | - Yinyin Yuan
- Centre for Evolution and Cancer; Division of Molecular Pathology, The Institute of Cancer Research, London, UK
| | - Rajendra Singh
- Icahn School of Medicine at Mt. Sinai, New York, NY 10029 USA
| | - Crispin Hiley
- Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, University College London, London, UK
| | - Maise al Bakir
- Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, University College London, London, UK
| | - Alexander J. Lazar
- Departments of Pathology, Genomic Medicine, Dermatology, and Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Stephen Naber
- Department of Pathology and Laboratory Medicine, Tufts Medical Center, Boston, USA
| | - Stephan Wienert
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Pathology, Charitéplatz 1, 10117 Berlin, Germany
| | - Miluska Castillo
- Department of Medical Oncology and Research, Instituto Nacional de Enfermedades Neoplasicas, Lima, 15038 Peru
| | | | - Maria-Vittoria Dieci
- Medical Oncology 2, Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
| | - Fabrice André
- Department of Medical Oncology, Institut Gustave Roussy, Villejuif, France
| | - Charles Swanton
- Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, University College London, London, UK
- Francis Crick Institute, Midland Road, London, UK
| | - Jorge Reis-Filho
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY USA
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, NY USA
| | - Joseph Sparano
- Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY USA
| | - Eva Balslev
- Department of Pathology, Herlev and Gentofte Hospital, Herlev, Denmark
| | - I-Chun Chen
- Department of Oncology, National Taiwan University Cancer Center, Taipei, Taiwan
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
- Graduate Institute of Oncology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | | | - Katherine Pogue-Geile
- National Surgical Adjuvant Breast and Bowel Project (NSABP)/NRG Oncology, Pittsburgh, PA USA
| | - Kim R. M. Blenman
- Department of Internal Medicine, Section of Medical Oncology, Yale Cancer Center, Yale School of Medicine, New Haven, CT USA
| | | | - Stuart Schnitt
- Department of Pathology, Brigham and Women’s Hospital, Boston, MA USA
| | - Sunil R. Lakhani
- The University of Queensland Centre for Clinical Research and Pathology Queensland, Brisbane, QLD Australia
| | - Anne Vincent-Salomon
- Institut Curie, Paris Sciences Lettres Université, Inserm U934, Department of Pathology, Paris, France
| | - Federico Rojo
- Pathology Department, Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD) - CIBERONC, Madrid, Spain
- GEICAM-Spanish Breast Cancer Research Group, Madrid, Spain
| | - Jeremy P. Braybrooke
- Nuffield Department of Population Health, University of Oxford, Oxford and Department of Medical Oncology, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Matthew G. Hanna
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY USA
| | - M. Teresa Soler-Monsó
- Department of Pathology, Bellvitge University Hospital, IDIBELL. Breast Unit. Catalan Institut of Oncology. L ‘Hospitalet del Llobregat’, Barcelona, 08908 Catalonia Spain
| | - Daniel Bethmann
- University Hospital Halle (Saale), Institute of Pathology, Halle (Saale), Germany
| | - Carlos A. Castaneda
- Department of Medical Oncology and Research, Instituto Nacional de Enfermedades Neoplasicas, Lima, 15038 Peru
| | - Karen Willard-Gallo
- Molecular Immunology Unit, Institut Jules Bordet, Universitè Libre de Bruxelles, Brussels, Belgium
| | - Ashish Sharma
- Department of Biomedical Informatics, Emory University, Atlanta, GA USA
| | - Huang-Chun Lien
- Department of Pathology, National Taiwan University Hospital, Taipei, Taiwan
| | - Susan Fineberg
- Department of Pathology, Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY USA
| | - Jeppe Thagaard
- DTU Compute, Department of Applied Mathematics, Technical University of Denmark; Visiopharm A/S, Hørsholm, Denmark
| | - Laura Comerma
- GEICAM-Spanish Breast Cancer Research Group, Madrid, Spain
- Pathology Department, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
| | - Paula Gonzalez-Ericsson
- Breast Cancer Program, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN USA
| | - Edi Brogi
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY USA
| | - Sherene Loi
- Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria Australia
- Division of Research and Cancer Medicine, Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, VIC Australia
| | - Joel Saltz
- Biomedical Informatics Department, Stony Brook University, Stony Brook, NY USA
| | - Frederick Klaushen
- Institute of Pathology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Lee Cooper
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL USA
| | - Mohamed Amgad
- Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, GA USA
| | - David A. Moore
- Department of Pathology, UCL Cancer Institute, UCL, London, UK
- University College Hospitals NHS Trust, London, UK
| | - Roberto Salgado
- Division of Research and Cancer Medicine, Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, VIC Australia
- Department of Pathology, GZA-ZNA, Antwerp, Belgium
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5
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Amgad M, Stovgaard ES, Balslev E, Thagaard J, Chen W, Dudgeon S, Sharma A, Kerner JK, Denkert C, Yuan Y, AbdulJabbar K, Wienert S, Savas P, Voorwerk L, Beck AH, Madabhushi A, Hartman J, Sebastian MM, Horlings HM, Hudeček J, Ciompi F, Moore DA, Singh R, Roblin E, Balancin ML, Mathieu MC, Lennerz JK, Kirtani P, Chen IC, Braybrooke JP, Pruneri G, Demaria S, Adams S, Schnitt SJ, Lakhani SR, Rojo F, Comerma L, Badve SS, Khojasteh M, Symmans WF, Sotiriou C, Gonzalez-Ericsson P, Pogue-Geile KL, Kim RS, Rimm DL, Viale G, Hewitt SM, Bartlett JMS, Penault-Llorca F, Goel S, Lien HC, Loibl S, Kos Z, Loi S, Hanna MG, Michiels S, Kok M, Nielsen TO, Lazar AJ, Bago-Horvath Z, Kooreman LFS, van der Laak JAWM, Saltz J, Gallas BD, Kurkure U, Barnes M, Salgado R, Cooper LAD. Report on computational assessment of Tumor Infiltrating Lymphocytes from the International Immuno-Oncology Biomarker Working Group. NPJ Breast Cancer 2020; 6:16. [PMID: 32411818 PMCID: PMC7217824 DOI: 10.1038/s41523-020-0154-2] [Citation(s) in RCA: 74] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 02/18/2020] [Indexed: 02/07/2023] Open
Abstract
Assessment of tumor-infiltrating lymphocytes (TILs) is increasingly recognized as an integral part of the prognostic workflow in triple-negative (TNBC) and HER2-positive breast cancer, as well as many other solid tumors. This recognition has come about thanks to standardized visual reporting guidelines, which helped to reduce inter-reader variability. Now, there are ripe opportunities to employ computational methods that extract spatio-morphologic predictive features, enabling computer-aided diagnostics. We detail the benefits of computational TILs assessment, the readiness of TILs scoring for computational assessment, and outline considerations for overcoming key barriers to clinical translation in this arena. Specifically, we discuss: 1. ensuring computational workflows closely capture visual guidelines and standards; 2. challenges and thoughts standards for assessment of algorithms including training, preanalytical, analytical, and clinical validation; 3. perspectives on how to realize the potential of machine learning models and to overcome the perceptual and practical limits of visual scoring.
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Affiliation(s)
- Mohamed Amgad
- Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, GA USA
| | | | - Eva Balslev
- Department of Pathology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark
| | - Jeppe Thagaard
- DTU Compute, Department of Applied Mathematics, Technical University of Denmark, Lyngby, Denmark
- Visiopharm A/S, Hørsholm, Denmark
| | - Weijie Chen
- FDA/CDRH/OSEL/Division of Imaging, Diagnostics, and Software Reliability, Silver Spring, MD USA
| | - Sarah Dudgeon
- FDA/CDRH/OSEL/Division of Imaging, Diagnostics, and Software Reliability, Silver Spring, MD USA
| | - Ashish Sharma
- Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, GA USA
| | | | - Carsten Denkert
- Institut für Pathologie, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg, Philipps-Universität Marburg, Marburg, Germany
- Institute of Pathology, Philipps-University Marburg, Marburg, Germany
- German Cancer Consortium (DKTK), Partner Site Charité, Berlin, Germany
| | - Yinyin Yuan
- Centre for Evolution and Cancer, The Institute of Cancer Research, London, UK
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK
| | - Khalid AbdulJabbar
- Centre for Evolution and Cancer, The Institute of Cancer Research, London, UK
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK
| | - Stephan Wienert
- Institut für Pathologie, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg, Philipps-Universität Marburg, Marburg, Germany
| | - Peter Savas
- Division of Research and Cancer Medicine, Peter MacCallum Cancer Centre, University of Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia
| | - Leonie Voorwerk
- Department of Tumor Biology & Immunology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | | | - Anant Madabhushi
- Case Western Reserve University, Department of Biomedical Engineering, Cleveland, OH USA
- Louis Stokes Cleveland Veterans Administration Medical Center, Cleveland, OH USA
| | - Johan Hartman
- Department of Oncology and Pathology, Karolinska Institutet and University Hospital, Solna, Sweden
| | - Manu M. Sebastian
- Departments of Epigenetics and Molecular Carcinogenesis, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Hugo M. Horlings
- Division of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Jan Hudeček
- Department of Research IT, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Francesco Ciompi
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - David A. Moore
- Department of Pathology, UCL Cancer Institute, London, UK
| | - Rajendra Singh
- Department of Pathology and Laboratory Medicine, Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Elvire Roblin
- Université Paris-Saclay, Univ. Paris-Sud, Villejuif, France
| | - Marcelo Luiz Balancin
- Department of Pathology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Marie-Christine Mathieu
- Department of Medical Biology and Pathology, Gustave Roussy Cancer Campus, Villejuif, France
| | - Jochen K. Lennerz
- Department of Pathology, Massachusetts General Hospital, Boston, MA USA
| | - Pawan Kirtani
- Department of Histopathology, Manipal Hospitals Dwarka, New Delhi, India
| | - I-Chun Chen
- Department of Oncology, National Taiwan University Cancer Center, Taipei, Taiwan
| | - Jeremy P. Braybrooke
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
- Department of Medical Oncology, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Giancarlo Pruneri
- Pathology Department, Fondazione IRCCS Istituto Nazionale Tumori and University of Milan, School of Medicine, Milan, Italy
| | | | - Sylvia Adams
- Laura and Isaac Perlmutter Cancer Center, NYU Langone Medical Center, New York, NY USA
| | - Stuart J. Schnitt
- Department of Pathology, Brigham and Women’s Hospital, Boston, MA USA
| | - Sunil R. Lakhani
- The University of Queensland Centre for Clinical Research and Pathology Queensland, Brisbane, Australia
| | - Federico Rojo
- Pathology Department, CIBERONC-Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD), Madrid, Spain
- GEICAM-Spanish Breast Cancer Research Group, Madrid, Spain
| | - Laura Comerma
- Pathology Department, CIBERONC-Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD), Madrid, Spain
- GEICAM-Spanish Breast Cancer Research Group, Madrid, Spain
| | - Sunil S. Badve
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN USA
| | | | - W. Fraser Symmans
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Christos Sotiriou
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Brussels, Belgium
- ULB-Cancer Research Center (U-CRC) Université Libre de Bruxelles, Brussels, Belgium
| | - Paula Gonzalez-Ericsson
- Breast Cancer Program, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN USA
| | | | | | - David L. Rimm
- Department of Pathology, Yale University School of Medicine, New Haven, CT USA
| | - Giuseppe Viale
- Department of Pathology, IEO, European Institute of Oncology IRCCS & State University of Milan, Milan, Italy
| | - Stephen M. Hewitt
- Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, MD USA
| | - John M. S. Bartlett
- Ontario Institute for Cancer Research, Toronto, ON Canada
- Edinburgh Cancer Research Centre, Western General Hospital, Edinburgh, UK
| | - Frédérique Penault-Llorca
- Department of Pathology and Molecular Pathology, Centre Jean Perrin, Clermont-Ferrand, France
- UMR INSERM 1240, Universite Clermont Auvergne, Clermont-Ferrand, France
| | - Shom Goel
- Victorian Comprehensive Cancer Centre building, Peter MacCallum Cancer Centre, Melbourne, Victoria Australia
| | - Huang-Chun Lien
- Department of Pathology, National Taiwan University Hospital, Taipei, Taiwan
| | - Sibylle Loibl
- German Breast Group, c/o GBG-Forschungs GmbH, Neu-Isenburg, Germany
| | - Zuzana Kos
- Department of Pathology, BC Cancer, Vancouver, British Columbia Canada
| | - Sherene Loi
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia
- Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Matthew G. Hanna
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY USA
| | - Stefan Michiels
- Gustave Roussy, Universite Paris-Saclay, Villejuif, France
- Université Paris-Sud, Institut National de la Santé et de la Recherche Médicale, Villejuif, France
| | - Marleen Kok
- Division of Molecular Oncology & Immunology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
- Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | | | - Alexander J. Lazar
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX USA
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
- Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | | | - Loes F. S. Kooreman
- GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of Pathology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jeroen A. W. M. van der Laak
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
- Center for Medical Image Science and Visualization, Linköping University, Linköping, Sweden
| | - Joel Saltz
- Department of Biomedical Informatics, Stony Brook University, Stony Brook, NY USA
| | - Brandon D. Gallas
- FDA/CDRH/OSEL/Division of Imaging, Diagnostics, and Software Reliability, Silver Spring, MD USA
| | - Uday Kurkure
- Roche Tissue Diagnostics, Digital Pathology, Santa Clara, CA USA
| | - Michael Barnes
- Roche Diagnostics Information Solutions, Belmont, CA USA
| | - Roberto Salgado
- Division of Research and Cancer Medicine, Peter MacCallum Cancer Centre, University of Melbourne, Victoria, Australia
- Department of Pathology, GZA-ZNA Ziekenhuizen, Antwerp, Belgium
| | - Lee A. D. Cooper
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL USA
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