Last year, we applied a digital pathology management platform 'Slide Score' as a risk management framework for integration of stromal Tumor-Infiltrating Lymphocytes (sTILs) in a clinical trial (Adaptive phase II randomized trial of nivolumab after induction treatment in triple-negative breast cancer; TONIC trial, led by Marleen Kok) to minimize potential risks of using multi-centre pathology assessment to stratify patients in clinical trials (Figure 1).
Using Slide Score for pathology support in the TONIC simplified distribution of slides and collection of assessments from pathologists spread over three different institutions. Using a web browser, pathologists were able to assess the slides from home on a tablet which contributed to shorter times needed to get a consensus score needed to stratify patients. Additionally, Slide Score ensured assessments were linked to the slides and the pathologists who made them. All this helped reduce the time patients had to wait before continuing treatment - the median time between biopsy (taking a sample) and assignment to a treatment arm was reduced from the usual 10 days to just over 2 days.
