title: Strategies for clinical implementation of TNM-Immunoscore in resected nonsmall-cell lung cancer.
abstract: Immunoscore is a prognostic tool defined to quantify in situ immune cell infiltrates and appears highly promising as a supplement to the tumor-node-metastasis (TNM) classification of various tumors. In colorectal cancer, an international task force has initiated prospective multicenter studies aiming to implement TNM-Immunoscore (TNM-I) in a routine clinical setting. In breast cancer, recommendations for the evaluation of tumor-infiltrating lymphocytes (TILs) have been proposed by an international working group. Regardless of promising results, there are potential obstacles related to implementing TNM-I into the clinic. Diverse methods may be needed for different malignancies and even within each cancer entity. Nevertheless, a uniform approach across malignancies would be advantageous. In nonsmall-cell lung cancer (NSCLC), there are several previous reports indicating an apparent prognostic importance of TILs, but studies on TILs in a TNM-I setting are sparse and no general recommendations are made. However, recently published data is promising, evoking a realistic hope of a clinical useful NSCLC TNM-I. This review will focus on the TNM-I potential in NSCLC and propose strategies for clinical implementation of a TNM-I in resected NSCLC.
authors.affiliation: Department of Oncology, University Hospital of North Norway, Tromso Institute of Clinical Medicine, The Arctic University of Norway, Tromso tom.donnem@uit.no.
authors.forename: T
authors.initials: T
authors.lastname: Donnem
authors.affiliation: Department of Oncology, University Hospital of North Norway, Tromso.
authors.forename: T K
authors.initials: TK
authors.lastname: Kilvaer
authors.affiliation: Department of Oncology, University Hospital of North Norway, Tromso.
authors.forename: S
authors.initials: S
authors.lastname: Andersen
authors.affiliation: Department of Clinical Pathology, University Hospital of North Norway, Tromso Institute of Medical Biology, The Arctic University of Norway, Tromso.
authors.forename: E
authors.initials: E
authors.lastname: Richardsen
authors.affiliation: Department of Oncology, University Hospital of North Norway, Tromso Institute of Clinical Medicine, The Arctic University of Norway, Tromso.
authors.forename: E E
authors.initials: EE
authors.lastname: Paulsen
authors.affiliation: Institute of Clinical Medicine, The Arctic University of Norway, Tromso.
authors.forename: S M
authors.initials: SM
authors.lastname: Hald
authors.affiliation: Department of Clinical Pathology, University Hospital of North Norway, Tromso Institute of Medical Biology, The Arctic University of Norway, Tromso.
authors.forename: S
authors.initials: S
authors.lastname: Al-Saad
authors.affiliation: Department of Oncology, Oslo University Hospital, The Norwegian Radium Hospital, Oslo.
authors.forename: O T
authors.initials: OT
authors.lastname: Brustugun
authors.affiliation: Department of Oncology, Oslo University Hospital, The Norwegian Radium Hospital, Oslo Department of Cancer Genetics, Oslo University Hospital, The Norwegian Radium Hospital, Oslo.
authors.forename: A
authors.initials: A
authors.lastname: Helland
authors.affiliation: Department of Pathology, Oslo University Hospital, The Norwegian Radium Hospital, Oslo.
authors.forename: M
authors.initials: M
authors.lastname: Lund-Iversen
authors.affiliation: Department of Cardiothoracic Surgery, Oslo University Hospital, Rikshospitalet, Oslo.
authors.forename: S
authors.initials: S
authors.lastname: Solberg
authors.affiliation: The Cancer Clinic, St Olavs Hospital, Trondheim University Hospital, Trondheim Department of Cancer Research and Molecular Medicine, European Palliative Care Research Centre, Norwegian University of Science and Technology, Trondheim.
authors.forename: B H
authors.initials: BH
authors.lastname: Gronberg
authors.affiliation: Department of Pathology and Medical Genetics, St Olavs Hospital-Trondheim University Hospital, Trondheim.
authors.forename: S G F
authors.initials: SG
authors.lastname: Wahl
authors.affiliation: Department of Pathology, Haukeland University Hospital, Bergen, Norway.
authors.forename: L
authors.initials: L
authors.lastname: Helgeland
authors.affiliation: Department of Thoracic Medicine, Haukeland University Hospital, Bergen, Norway.
authors.forename: O
authors.initials: O
authors.lastname: Fløtten
authors.affiliation: Department of Oncology, Rigshospitalet, Copenhagen, Denmark.
authors.forename: M
authors.initials: M
authors.lastname: Pohl
authors.affiliation: Department of Pathology, Nordland Hospital, Bodo.
authors.forename: K
authors.initials: K
authors.lastname: Al-Shibli
authors.affiliation: Department of Community Medicine, The Artic University of Tromso, Tromso, Norway.
authors.forename: T M
authors.initials: TM
authors.lastname: Sandanger
authors.affiliation: Nuffield Department of Clinical Laboratory Sciences, University of Oxford, John Radcliffe Hospital, Oxford, UK.
authors.forename: F
authors.initials: F
authors.lastname: Pezzella
authors.affiliation: Department of Clinical Pathology, University Hospital of North Norway, Tromso Institute of Medical Biology, The Arctic University of Norway, Tromso.
authors.forename: L T
authors.initials: LT
authors.lastname: Busund
authors.affiliation: Department of Oncology, University Hospital of North Norway, Tromso Institute of Clinical Medicine, The Arctic University of Norway, Tromso.
authors.forename: R M
authors.initials: RM
authors.lastname: Bremnes
mesh_terms: D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis / Q000401:mortality / Q000473:pathology*; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000473:pathology*; D016246:Lymphocytes, Tumor-Infiltrating / Q000276:immunology / Q000473:pathology*; D009362:Neoplasm Metastasis / Q000175:diagnosis / Q000473:pathology; D009367:Neoplasm Staging; D011379:Prognosis; D012720:Severity of Illness Index; D059016:Tumor Microenvironment / Q000276:immunology
keywords: NSCLC; T cells; TNM-I; immunoscore; lung cancer