Skok Kristijan, Maccio Umberto, Martin Spencer D, Bräutigam Konstantin
Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria.
Institute of Biomedical Sciences, Faculty of Medicine, University of Maribor, Maribor, Slovenia.
Cancer Med. 2025 Jul;14(13):e71023. doi: 10.1002/cam4.71023.
BACKGROUND: The growing success of cancer immunotherapies has led to significant advances in oncology. However, despite these promising developments, cancer-related mortality remains high for common cancer types such as breast and lower female genital tract cancers. METHOD: Here, we synthesize recent findings on the prognostic relevance of tumor-infiltrating lymphocytes (TILs) in breast, endometrial, tubo-ovarian, and vulvar cancer. Our analysis covers the relationship between TIL counts and density, immune cell subtype combinations, immunotherapy approaches, and patient outcomes. RESULTS: High TIL infiltration, especially CD8 T-cells, generally correlates with improved outcomes such as in endometrial cancer (especially the POLE-ultramutated subgroup), invasive breast cancer, and ovarian epithelial tumors. However, in ductal carcinoma in situ (DCIS) of the breast, elevated TIL counts are linked to a worse prognosis. Ethnicity, the tumor microenvironment (TME), and molecular profiles further complicate the prognostic utility of TILs. CONCLUSIONS: TIL-based therapies have shown potential in personalized immunotherapy, particularly in recurrent, refractory ovarian cancer. Limited research on rarer gynecologic tumors hinders broader clinical applications.
背景:癌症免疫疗法的不断成功推动了肿瘤学的重大进展。然而,尽管有这些令人鼓舞的进展,但对于乳腺癌和女性下生殖道癌等常见癌症类型,癌症相关死亡率仍然很高。 方法:在此,我们综合了关于肿瘤浸润淋巴细胞(TILs)在乳腺癌、子宫内膜癌、输卵管卵巢癌和外阴癌中的预后相关性的最新研究结果。我们的分析涵盖了TIL计数与密度、免疫细胞亚型组合、免疫治疗方法和患者预后之间的关系。 结果:高TIL浸润,尤其是CD8 T细胞,通常与更好的预后相关,如在子宫内膜癌(特别是POLE超突变亚组)、浸润性乳腺癌和卵巢上皮肿瘤中。然而,在乳腺导管原位癌(DCIS)中,TIL计数升高与更差的预后相关。种族、肿瘤微环境(TME)和分子特征进一步使TILs的预后效用复杂化。 结论:基于TIL的疗法在个性化免疫治疗中显示出潜力,特别是在复发性、难治性卵巢癌中。对罕见妇科肿瘤的研究有限阻碍了更广泛的临床应用。
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