Making sense of TILs: recommendations for morphological assessment of tumour-infiltrating lymphocytes in gastro-oesophageal carcinoma

Weeda YA, Salgado R, van Herpe F, Sur D, Vieth M, Loi S, Tafti AP, Alexandros H, Hida AI, Bhalla A, Khramtsov AI, Ehinger A, Tanaka A, Acs B, Ercan C, Focke CM, Ehinger D, Huang D, Khramtsova GF, Nishida H, Li N, Littlefield N, Steen S, Sevim S, Ichihara S, Morikawa S, Michiels S, Papathomas T, Haga T, Gu Q, Sheng W, Kervadec H, Horlings HM, Sanchez-Vega F, Janjigian YY, Chalabi M, van Laarhoven HW, Kodach LL, Meijer SL (2026)

Publication Type: Journal article, Review article

Publication year: 2026

Journal

Book Volume: 88

Pages Range: 1126-1141

Journal Issue: 6

DOI: 10.1111/his.70089

Abstract

In the era of immune checkpoint inhibitors for cancers, the need for prognostic biomarkers to identify patients most likely to achieve a durable response has become increasingly more relevant. Tumour-infiltrating lymphocytes (TILs) have gained significant interest, as they can be evaluated using standard haematoxylin and eosin-stained slides, making it a widely accessible and cost-effective biomarker. In addition to their practicality, TILs provide prognostic insights into the interplay between the immune system and tumour cells. While the morphological assessment of TILs has been standardised in breast cancer, comprehensive guidelines for their evaluation in gastro-oesophageal carcinomas (GEC) are still lacking. This narrative review examines the current literature on the composition, clinical implications and therapeutic utility of TILs in GEC. These insights are used to propose a framework with recommendations for standardised evaluation and reporting of TILs in GEC, while also highlighting pitfalls specific to GEC pathology. These recommendations serve as a vital first step towards the widespread use and validation of TILs as a biomarker.

Authors with CRIS profile

Involved external institutions

University of Amsterdam Netherlands (NL) ZAS Hospitals / Ziekenhuis aan de Stroom Belgium (BE) University Hospital Leuven (UZ) / Universitaire ziekenhuizen Leuven Belgium (BE) Iuliu Hațieganu University of Medicine and Pharmacy / Universitatea de Medicină și Farmacie "Iuliu Hațieganu" (UMF Cluj) Romania (RO) Peter MacCallum Cancer Centre Australia (AU) University of Pittsburgh United States (USA) (US) University of London United Kingdom (GB) Matsuyama Shimin Hospital / 松山市民病院 Japan (JP) Cardiovascular Research Foundation United States (USA) (US) Skåne University Hospital / Skånes universitetssjukhus Sweden (SE) Harvard University United States (USA) (US) Karolinska University Hospital / Karolinska Universitetssjukhuset Sweden (SE) University of Texas MD Anderson Cancer Center United States (USA) (US) Dietrich-Bonhoeffer-Klinikum Germany (DE) Lund University / Lunds universitet Sweden (SE) University of Chicago United States (USA) (US) Oita University / 大分大学 Japan (JP) Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital (NKI / NKI-AVL) Netherlands (NL) Fudan University / 复旦大学 China (CN) Oregon Health and Science University (OSHU) United States (USA) (US) Sapporo-Kosei General Hospital / JA北海道厚生連札幌厚生病院 Japan (JP) Institut Gustave-Roussy France (FR) National Cancer Center Hospital Japan (JP) Amsterdam University Medical Centers (Amsterdam UMC) / Amsterdam Universitair Medische Centra Netherlands (NL) Memorial Sloan Kettering Cancer Center United States (USA) (US)

How to cite

APA:

Weeda, Y.A., Salgado, R., van Herpe, F., Sur, D., Vieth, M., Loi, S.,... Meijer, S.L. (2026). Making sense of TILs: recommendations for morphological assessment of tumour-infiltrating lymphocytes in gastro-oesophageal carcinoma. Histopathology, 88(6), 1126-1141. https://doi.org/10.1111/his.70089

MLA:

Weeda, Ylva A., et al. "Making sense of TILs: recommendations for morphological assessment of tumour-infiltrating lymphocytes in gastro-oesophageal carcinoma." Histopathology 88.6 (2026): 1126-1141.

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