Image‐based multiplex immune profiling of cancer tissues: translational implications. A report of the International Immuno‐oncology Biomarker Working Group on Breast Cancer
Authors: Jahangir Chowdhury Arif , Page David B , Broeckx Glenn , Gonzalez Claudia A , Burke Caoimbhe , Murphy Clodagh , Reis‐Filho Jorge S , Ly Amy , Harms Paul W , Gupta Rajarsi R , Vieth Michael , Hida Akira I , Kahila Mohamed , Kos Zuzana , van Diest Paul J , Verbandt Sara , Thagaard Jeppe , Khiroya Reena , Abduljabbar Khalid , Acosta Haab Gabriela , Acs Balazs , Adams Sylvia , Almeida Jonas S , Alvarado‐Cabrero Isabel , Azmoudeh‐Ardalan Farid , Badve Sunil , Baharun Nurkhairul Bariyah , Bellolio Enrique R , Bheemaraju Vydehi , Blenman Kim RM , Botinelly Mendonça Fujimoto Luciana , Burgues Octavio , Chardas Alexandros , Cheang Maggie Chon U , Ciompi Francesco , Cooper Lee AD , Coosemans An , Corredor Germán , Dantas Portela Flavio Luis , Deman Frederik , Demaria Sandra , Dudgeon Sarah N , Elghazawy Mahmoud , Fernandez‐Martín Claudio , Fineberg Susan , Fox Stephen B , Giltnane Jennifer M , Gnjatic Sacha , Gonzalez‐Ericsson Paula I , Grigoriadis Anita , Halama Niels , Hanna Matthew G , Harbhajanka Aparna , Hart Steven N , Hartman Johan , Hewitt Stephen , Horlings Hugo M , Husain Zaheed , Irshad Sheeba , Janssen Emiel AM , Kataoka Tatsuki R , Kawaguchi Kosuke , Khramtsov Andrey I , Kiraz Umay , Kirtani Pawan , Kodach Liudmila L , Korski Konstanty , Akturk Guray , Scott Ely , Kovács Anikó , Lænkholm Anne‐Vibeke , Lang‐Schwarz Corinna , Larsimont Denis , Lennerz Jochen K , Lerousseau Marvin , Li Xiaoxian , Madabhushi Anant , Maley Sai K , Manur Narasimhamurthy Vidya , Marks Douglas K , McDonald Elizabeth S , Mehrotra Ravi , Michiels Stefan , Kharidehal Durga , Minhas Fayyaz ul Amir Afsar , Mittal Shachi , Moore David A , Mushtaq Shamim , Nighat Hussain , Papathomas Thomas , Penault‐Llorca Frederique , Perera Rashindrie D , Pinard Christopher J , Pinto‐Cardenas Juan Carlos , Pruneri Giancarlo , Pusztai Lajos , Rajpoot Nasir Mahmood , Rapoport Bernardo Leon , Rau Tilman T , Ribeiro Joana M , Rimm David , Vincent‐Salomon Anne , Saltz Joel , Sayed Shahin , Hytopoulos Evangelos , Mahon Sarah , Siziopikou Kalliopi P , Sotiriou Christos , Stenzinger Albrecht , Sughayer Maher A , Sur Daniel , Symmans Fraser , Tanaka Sunao , Taxter Timothy , Tejpar Sabine , Teuwen Jonas , Thompson E Aubrey , Tramm Trine , Tran William T , van der Laak Jeroen , Verghese Gregory E , Viale Giuseppe , Wahab Noorul , Walter Thomas , Waumans Yannick , Wen Hannah Y , Yang Wentao , Yuan Yinyin , Bartlett John , Loibl Sibylle , Denkert Carsten , Savas Peter , Loi Sherene , Specht Stovgaard Elisabeth , Salgado Roberto , Gallagher William M , Rahman Arman 
Published: January 2024

Recent advances in the field of immuno‐oncology have brought transformative changes in the management of cancer patients. The immune profile of tumours has been found to have key value in predicting disease prognosis and treatment response in various cancers. Multiplex immunohistochemistry and immunofluorescence have emerged as potent tools for the simultaneous detection of multiple protein biomarkers in a single tissue section, thereby expanding opportunities for molecular and immune profiling while preserving tissue samples. By establishing the phenotype of individual tumour cells when distributed within a mixed cell population, the identification of clinically relevant biomarkers with high‐throughput multiplex immunophenotyping of tumour samples has great potential to guide appropriate treatment choices. Moreover, the emergence of novel multi‐marker imaging approaches can now provide unprecedented insights into the tumour microenvironment, including the potential interplay between various cell types. However, there are significant challenges to widespread integration of these technologies in daily research and clinical practice. This review addresses the challenges and potential solutions within a structured framework of action from a regulatory and clinical trial perspective. New developments within the field of immunophenotyping using multiplexed tissue imaging platforms and associated digital pathology are also described, with a specific focus on translational implications across different subtypes of cancer. © 2024 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.