Binnewies 2018: understanding the tumour immune microenvironment for effective therapy
A review that sorted tumours by where their immune cells sit, inflamed and infiltrated, infiltrated but excluded, or immune-poor, and argued that this classification should guide which immunotherapy a patient receives.
Overview
Binnewies, Krummel and colleagues proposed classifying the tumour immune microenvironment (TIME) by the density and position of immune cells: infiltrated-excluded tumours with T cells confined to the margins and stroma, infiltrated-inflamed tumours with T cells among the cancer cells and high PD-L1, and a subclass with tertiary lymphoid structures. They reviewed how these states arise from tumour genetics, the microbiome and host factors, how they predict response to checkpoint blockade, and how therapies including chemotherapy, radiotherapy and myeloid-targeting agents might convert excluded or cold tumours into inflamed ones.
- Tumour immune microenvironments fall into infiltrated-excluded, infiltrated-inflamed and tertiary lymphoid structure classes.
- Inflamed tumours with intratumoural T cells and PD-L1 are the most likely to respond to checkpoint blockade.
- Proposed therapeutic strategies to convert excluded or immune-poor tumours into inflamed ones.
This framework is behind the everyday language of hot and cold tumours and the design of combination trials that pair checkpoint inhibitors with treatments meant to draw T cells into the tumour.
- Classes are descriptive and the boundaries between them are not sharp.
- A review; prospective use of TIME classification to choose therapy is still being tested.
Similar pages
not linked directly; found by shared links- Key paperGalon 2006: the type, density and location of immune cells in colorectal tumours predict outcome
Shares Thorsson 2018: the immune landscape of cancer across 10,000 tumours, Immune system, Tumour-infiltrating lymphocytes (TILs).
- Key paperLi 2017: TIMER, a web server for estimating immune cells in tumour genomic data
Shares Thorsson 2018: the immune landscape of cancer across 10,000 tumours, Immune system, Tumour-infiltrating lymphocytes (TILs).
- Key paperSchreiber, Old and Smyth 2011: cancer immunoediting
Shares Thorsson 2018: the immune landscape of cancer across 10,000 tumours, Immune system, PD-L1, Immune checkpoint inhibitors.
- IdeaGrow immune command posts inside tumours
Shares Tumour-infiltrating lymphocytes (TILs), Hot vs cold tumours, Immune checkpoint inhibitors.
- TermImmune checkpoint
Shares Tumeh 2014: PD-1 blockade works by releasing T cells already present at the tumour edge, Immune system, Hot vs cold tumours, PD-L1.
- TermHallmark: avoiding immune destruction
Shares Immune system, Hot vs cold tumours, PD-L1, Immune checkpoint inhibitors.
- IdeaStandards for spatial and multiplex tissue biomarkers before they reach the clinic
Shares Tumour-infiltrating lymphocytes (TILs), Hot vs cold tumours.
- IdeaMap which tumour clones sit next to which immune cells before choosing therapy
Shares Tumour-infiltrating lymphocytes (TILs), Hot vs cold tumours.