Finkelman Brian S, Zhang Huina, Hicks David G, Rimm David L, Turner Bradley M
Department of Pathology & Laboratory Medicine, University of Rochester Medical Center, Rochester, NY, USA.
Department of Pathology, Yale University School of Medicine, New Haven, CT, USA.
Hum Pathol. 2025 Aug;162:105866. doi: 10.1016/j.humpath.2025.105866. Epub 2025 Jul 2.
Since Dr. Stephen Paget first proposed the "seed and soil" hypothesis in 1889, the tumor microenvironment has been recognized as a crucial component of tumor growth, progression, and metastasis. Tumor-infiltrating lymphocytes (TILs) are an important part of the tumor microenvironment, as well as an important prognostic and predictive biomarker for many cancers. This narrative review aims to summarize the current literature on the analytic validity, clinical validity, and clinical utility of TILs in breast cancer, including discussion of all major clinical subtypes. We summarize the current recommendations of the International Immuno-Oncology Biomarker Working Group on Breast Cancer for pathologist assessment and reporting of TILs, the state of the evidence justifying their usefulness as a biomarker in breast cancer, particularly for triple-negative and HER2+ breast cancer, as well as ongoing challenges and areas of future development, such as automated TIL scoring algorithms. Based on currently available evidence as well as ongoing clinical trials, we expect that TILs will increasingly become a cost-effective, easily available, and widely utilized biomarker in breast cancer, helping to guide treatment selection and optimization of therapy for many patients.
自1889年斯蒂芬·佩吉特博士首次提出“种子与土壤”假说以来，肿瘤微环境已被公认为肿瘤生长、进展和转移的关键组成部分。肿瘤浸润淋巴细胞（TILs）是肿瘤微环境的重要组成部分，也是许多癌症重要的预后和预测生物标志物。本叙述性综述旨在总结目前关于TILs在乳腺癌中的分析有效性、临床有效性和临床实用性的文献，包括对所有主要临床亚型的讨论。我们总结了国际免疫肿瘤生物标志物工作组关于乳腺癌中TILs病理学家评估和报告的当前建议、证明其作为乳腺癌生物标志物有用性的证据状况，特别是对于三阴性和HER2+乳腺癌，以及持续存在的挑战和未来发展领域，如TIL自动评分算法。基于目前可用的证据以及正在进行的临床试验，我们预计TILs将越来越成为乳腺癌中具有成本效益、易于获得且广泛使用的生物标志物，有助于指导许多患者的治疗选择和治疗优化。
