The tale of TILs in breast cancer: A report from The International Immuno-Oncology Biomarker Working Group

The advent of immune-checkpoint inhibitors (ICI) in modern oncology has significantly improved survival in several cancer settings. A subgroup of women with breast cancer (BC) has immunogenic infiltration of lymphocytes with expression of programmed death-ligand 1 (PD-L1). These patients may potentially benefit from ICI targeting the programmed death 1 (PD-1)/PD-L1 signaling axis. The use of tumor-infiltrating lymphocytes (TILs) as predictive and prognostic biomarkers has been under intense examination. Emerging data suggest that TILs are associated with response to both cytotoxic treatments and immunotherapy, particularly for patients with triple-negative BC. In this review from The International Immuno-Oncology Biomarker Working Group, we discuss (a) the biological understanding of TILs, (b) their analytical and clinical validity and efforts toward the clinical utility in BC, and (c) the current status of PD-L1 and TIL testing across different continents, including experiences from low-to-middle-income countries, incorporating also the view of a patient advocate. This information will help set the stage for future approaches to optimize the understanding and clinical utilization of TIL analysis in patients with BC.

Promises, promises

Once again, Congress and the President will try to balance the budget by slicing more out of nondefense discretionary spending. But there's not much meat left on those bones. The budget-meisters will try to spend and save. The result could be empty promises.

Showdown time

There may not be a train wreck this fall, but that doesn't mean that there won't be some close calls as the White House and Congress come to grips on such issues as spending and taxes, health care, welfare and the environment.

The big fix

Republicans are talking about making at least $100 billion in cuts or reductions in the growth of medicare--the highly popular, though increasingly unaffordable, health program for older Americans. But is taking on medicare a political poison pill?

Differential effects of relaxation techniques on trait anxiety: a meta-analysis

Hand and computer searches located studies on the effects of relaxation techniques on trait anxiety. Effect sizes for the different treatments (e.g., Progressive Relaxation, EMG Biofeedback, various forms of meditation, etc.) were calculated. Most of the treatments produced similar effect sizes except that Transcendental Meditation had significantly larger effect size (p less than .005), and meditation that involved concentration had significantly smaller effect. Correlations with effect size were calculated for many variables, e.g., population, age, sex, experimental design, duration and hours of treatment, pretest anxiety, demand characteristics, experimenter attitude, type of publication, attrition, etc. Only a few variables (mainly population, duration, hours, and attrition) significantly influenced effect size. Controlling for possible confounding variables did not alter the overall conclusions. The difference in effect size between treatments was maintained both when only published studies were included and when only the studies with the strongest design were included. Possible explanations for the findings are examined.