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medRxiv

Tumour region identification guided scoring (TRIGS) and foundation model-based Tumour Infiltrating Lymphocyte scoring are prognostic for pathological complete response/event free survival in the triple negative patients in the PARTNER randomized controlled trial

This study updated an automated tumour infiltrating lymphocyte (TIL) assessment pipeline, proposing TRIGS aligned with clinical scoring guidelines and foundation model-based SAM-TIL, and showed in 166 neoadjuvantly treated patients in the TransNEO cohort that they predicted pathological complete response with odds ratios of 1.95 (95% CI 1.22-3.03, p=0.005) and 2.32 (95% CI 1.43-3.77, p=0.001), and in 277 triple negative and HER2-positive patients in The Cancer Genome Atlas showed overall survival hazard ratios of 0.79 (95% CI 0.63-1.00, p=0.05) and 0.80 (95% CI 0.67-0.97, p=0.02), with correlation to gold standard clinical assessment of 0.59-0.69 and no substantial difference from gold standard assessment in predicting pathological complete response (AUC 0.60-0.