Bhumsuk Keam

Background This study analyzed the predictive value of artificial intelligence (AI)‐powered tumor‐infiltrating lymphocyte (TIL) analysis in recurrent or metastatic (R/M) adenoid cystic carcinoma (ACC) treated with axitinib. Methods Patients from a multicenter, prospective phase II trial evaluating axitinib efficacy in R/M ACC were included in this study. H&E whole‐side images of archival tumor tissues were analyzed by Lunit SCOPE IO, an AI‐powered spatial TIL analyzer. Results Twenty‐seven patients were included in the analysis. The best response was stable disease, and the median progression‐free survival (PFS) was 11.1 months (95% CI, 9.2–13.7 months). Median TIL densities in the cancer and surrounding stroma were 25.8/mm 2 (IQR, 8.3–73.0) and 180.4/mm 2 (IQR, 69.6–342.8), respectively. Patients with stromal TIL density >342.5/mm 2 exhibited longer PFS ( p = 0.012). Conclusions Cancer and stromal area TIL infiltration were generally low in R/M ACC. Higher stromal TIL infiltration was associated with a longer PFS with axitinib treatment.