Prognostic significance of tumor-infiltrating lymphocytes

• Kiselevskiy M.V.
• Vlasenko R.Ya.
• Tatiana N. Zabotina
• Zaira G. Kadagidze

Abstract

The analysis shows that, despite numerous clinical studies of prognostic significance of infiltrating lymphocytes (TIL) in various types of malignant tumors, there is no single point of view on this problem. The greatest material was accumulated in the evaluation of TIL as a prognostic factor for the duration of General and relapse-free survival and the effectiveness of neoadjuvant therapy in breast cancer patients. Although the meta-analysis carried out in the review publications showed a high level of correlation between the intensity of tumor infiltration by lymphocytes and survival of patients with breast cancer, as well as with the effectiveness of neoadjuvant therapy, similar patterns were noted not for all variants of this pathology. Even more contradictions arise in the evaluation of the predictor role of various lymphocyte subpopulations. In particular, various studies have shown a positive correlation between the percentage of both cytotoxic CD8⁺ TIL and suppressor FOXP3⁺ TIL. Obviously, for this reason, according to the recommendations of the German Breast Group, it is proposed to evaluate the infiltration of tumor lymphocytes using standard histological staining with hematoxylin-eosin without isolation of individual lymphocyte subpopulations. An even more complex and ambiguous interpretation of the prognostic significance of TIL and their subtypes is observed in other localizations of malignant tumors, which is obviously due to the small number of patients included in the study.

Along with the predictive value of TIL for chemotherapy, tumor-infiltrating lymphocytes can also be predictive biomarkers of immunotherapy effectiveness. In particular, new immunotherapy drugs pembrolizumab, nivolumab, etc. can effectively enhance the antitumor effect of CD8⁺ TIL. Therefore, the degree of severity and subpopulation composition of lymphoid infiltration of the tumor can be considered not only as a prognostic factor in the course of cancer, but also be important for the selection of individualized treatment, including modern immunotherapeutic drugs. Literature analysis and clinical trials were conducted on databases Scopus, WebofScience, PubMed, Clinical trial. gov and RISC.

Keywords:tumor filtering lymphocytes; prognostic value; malignant neoplasms; overview

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