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To establish a clinically relevant TILs cut-off for patients with oesophago-gastric (OG) cancer, it is essential to know whether TILs density varies by patient and\/or disease characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>\n                      TILs were quantified as TILs\/mm\n                      <jats:sup>2<\/jats:sup>\n                      (TILs density) by a deep-learning algorithm applied to digitised Haematoxylin\/Eosin (H&amp;E)-stained biopsies and resection specimens from 4628 patients from nine phase III trials. 4533 patients with TILs density and matched clinicopathological data were included in the final analyses. Associations between TILs density, disease stage, geographical region (UK versus Asia), sex, age, and treatment were analysed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Median TILs density was higher in pre-treatment biopsies from patients with early-stage versus late-stage disease (962 vs 479 TILs\/mm\n                      <jats:sup>2<\/jats:sup>\n                      ,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Within the same geographical region and disease stage, TILs density was similar across different chemotherapy regimens. In UK-led trials of early-stage disease, post-chemotherapy resections showed higher TILs density than chemotherapy-na\u00efve resections (618 vs 571 TILs\/mm\n                      <jats:sup>2<\/jats:sup>\n                      ,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003). TILs density was higher in Asian tumours compared to UK tumours (1419 vs 571 TILs\/mm\n                      <jats:sup>2<\/jats:sup>\n                      ,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). No significant associations were observed with age or sex.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This is the largest study to date evaluating TILs density in OG cancer. TILs density varied with stage and geographical region but not by age or sex. These findings may explain enhanced response to immunotherapy observed in published studies of patients with early-stage disease and highlight the need to account for baseline TILs heterogeneity when interpreting TILs as a possible biomarker in future studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10120-026-01739-6","type":"journal-article","created":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T06:19:43Z","timestamp":1777961983000},"page":"762-776","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The density of tumour infiltrating lymphocytes in oesophago-gastric cancer varies with disease stage, geographical region and treatment: a post hoc analysis of nine phase III clinical trials"],"prefix":"10.1007","volume":"29","author":[{"given":"Georgina 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Judith de Vos-Geelen has received institutional research funding from Servier, outside the submitted work. Nicholas P. West has received consultancy payments from Astellas, BMS, Pfizer, Amgen, Servier and GSK and research funding from GSK, Pierre Fabre, Roche Diagnostics and Adlai Nortye. Derek Magee is a director of HeteroGenius limited. HeteroGenius MIM software was used in this work for annotation, model building and cell detection. HeteroGenius Limited provided no funding towards this work, and software was purchased under commercial terms. David Cunningham has been awarded a grant from Clovis, Eli Lilly, 4SC, Bayer, Celgene, NIHR EME and Roche for other clinical research, and it is outside of the scope of the submitted work. Dr Katharina von Logo works at Waiv company.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}