Abstract

Stromal tumor-infiltrating lymphocytes (sTILs) are a potential predictive biomarker for immunotherapy response in metastatic triple-negative breast cancer (TNBC). To incorporate sTILs into clinical trials and diagnostics, reliable assessment is essential. In this review, we propose a new concept, namely the implementation of a risk-management framework that enables the use of sTILs as a stratification factor in clinical trials. We present the design of a biomarker risk-mitigation workflow that can be applied to any biomarker incorporation in clinical trials. We demonstrate the implementation of this concept using sTILs as an integral biomarker in a single-center phase II immunotherapy trial for metastatic TNBC (TONIC trial, NCT02499367), using this workflow to mitigate risks of suboptimal inclusion of sTILs in this specific trial. In this review, we demonstrate that a web-based scoring platform can mitigate potential risk factors when including sTILs in clinical trials, and we argue that this framework can be applied for any future biomarker-driven clinical trial setting.

Details

Title
Application of a risk-management framework for integration of stromal tumor-infiltrating lymphocytes in clinical trials
Author
Hudeček, Jan 1   VIAFID ORCID Logo  ; Voorwerk Leonie 2 ; Maartje, van Seijen 3 ; Nederlof Iris 2 ; de Maaker Michiel 3 ; van den Berg Jose 4 ; van de Vijver Koen K 5   VIAFID ORCID Logo  ; Sikorska Karolina 6 ; Adams, Sylvia 7 ; Demaria, Sandra 8   VIAFID ORCID Logo  ; Viale Giuseppe 9 ; Nielsen, Torsten O 10 ; Badve, Sunil S 11   VIAFID ORCID Logo  ; Michiels, Stefan 12 ; Symmans William Fraser 13   VIAFID ORCID Logo  ; Sotiriou Christos 14 ; Rimm, David L 15   VIAFID ORCID Logo  ; Hewitt, Stephen M 16 ; Denkert Carsten 17 ; Loibl Sibylle 18 ; Loi Sherene 19   VIAFID ORCID Logo  ; Bartlett, John M, S 20 ; Pruneri Giancarlo 21 ; Dillon, Deborah A 22 ; Cheang Maggie C U 23 ; Tutt, Andrew 24 ; Hall, Jacqueline A 25   VIAFID ORCID Logo  ; Kos Zuzana 26 ; Salgado, Roberto 27 ; Kok Marleen 28 ; Horlings Hugo M 29   VIAFID ORCID Logo  ; Hyytiäinen Aini 30 ; Hida, Akira I 31 ; Thompson, Alastair 32 ; Lefevre, Alex 33 ; Lazar, Alexander J 34 ; Gown Allen 35 ; Lo, Amy 36 ; Sapino, Anna 37 ; Madabhushi Anant 38 ; Moreira, Andre 39 ; Richardson, Andrea 40 ; Vingiani Andrea 41 ; Beck, Andrew H 42 ; Bellizzi, Andrew M 43 ; Guerrero, Angel 44 ; Grigoriadis, Anita 45 ; Ehinger, Anna 46 ; Garrido-Castro, Ana 47 ; Vincent-Salomon, Anne 48 ; Anne-Vibeke, Laenkholm 49 ; Sharma, Ashish 50 ; Cimino-Mathews, Ashley 51 ; Srinivasan, Ashok 52 ; Acs Balazs 53 ; Singh, Baljit 54 ; Calhoun, Benjamin 55 ; Benjamin, Haibe-Kans 56 ; Solomon, Benjamin 57 ; Thapa Bibhusal 58 ; Nelson, Brad H 59 ; Gallas, Brandon D 60 ; Castaneda, Carlos 61 ; Ballesteros-Merino, Carmen 62 ; Criscitiello, Carmen 63 ; Boeckx Carolien 64 ; Colpaert Cecile 65 ; Quinn, Cecily 66 ; Chennubhotla, Chakra S 67 ; Swanton, Charles 68 ; Solinas Cinzia 69 ; Hiley Crispin 68 ; Drubay Damien 70 ; Bethmann, Daniel 71 ; Moore, David A 72 ; Larsimont Denis 73 ; Dhanusha, Sabanathan 74 ; Peeters Dieter 75 ; Zardavas Dimitrios 76 ; Höflmayer Doris 77 ; Johnson, Douglas B 78 ; Aubrey, Thompson E 79 ; Brogi Edi 80 ; Perez, Edith 81 ; ElGabry, Ehab A 82 ; Specht, Stovgaard Elisabeth 83 ; Blackley, Elizabeth F 57 ; Roblin Elvire 84 ; Reisenbichler Emily 85 ; Bellolio Enrique 86 ; Balslev, Eva 83 ; Chmielik Ewa 87 ; Gaire Fabien 88 ; Andre, Fabrice 89 ; Fang-I, Lu 90 ; Azmoudeh-Ardalan Farid 91 ; Rojo Federico 92 ; Gruosso Tina 93 ; Ciompi Francesco 94 ; Peale Franklin 95 ; Hirsch, Fred R 96 ; Klauschen Frederick 97 ; Penault-Llorca Frédérique 98 ; Acosta, Haab Gabriela 99 ; Gelareh, Farshid 100 ; van den Eynden Gert 101 ; Curigliano Giuseppe 102 ; Floris Giuseppe 103 ; Broeckx Glenn 104 ; Gonzalez-Ericsson 105 ; Koeppen Harmut 36 ; Haynes, Harry R 106 ; McArthur, Heather 107 ; Joensuu Heikki 108 ; Olofsson, Helena 109 ; Huang-Chun, Lien 110 ; I-Chun, Chen 111 ; Cree, Ian 112 ; Frahm, Isabel 113 ; Brcic Iva 114 ; Chan, Jack 115 ; Ziai, James 36 ; Brock, Jane 116 ; Wesseling Jelle 117 ; Giltnane, Jennifer 36 ; Kerner, Jennifer K 118 ; Thagaard Jeppe 119 ; Braybrooke, Jeremy P 120 ; van der Laak Jeroen A W M 121 ; Lemonnier Jerome 122 ; Zha Jiping 123 ; Ribeiro Joana 124 ; Lennerz, Jochen K 125 ; Carter, Jodi M 126 ; Saltz, Joel 127 ; Hartman, Johan 128 ; Hainfellner Johannes 129 ; Quesne John Le 130 ; Juco, Jonathon W 131 ; Reis-Filho, Jorge 132 ; Sanchez Joselyn 133 ; Sparano, Joseph 134 ; Cucherousset Joël 135 ; Araya, Juan Carlos 136 ; Julien, Adam 137 ; Balko, Justin M 138 ; Saeger Kai 139 ; Siziopikou Kalliopi 140 ; Willard-Gallo, Karen 141 ; Weber, Karsten 18 ; Pogue-Geile, Katherine L 142 ; Steele, Keith E 123 ; Emancipator, Kenneth 131 ; AbdulJabbar Khalid 143 ; El Bairi Khalid 144 ; Blenman Kim R M 145 ; Allison, Kimberly H 146 ; Korski Konstanty 147 ; Pusztai Lajos 145 ; Comerma, Laura 148 ; Buisseret Laurence 149 ; Cooper Lee A D 150 ; Shi Leming 151 ; Kooreman, Loes F, S 152 ; Molinero Luciana 153 ; Valeria, Estrada M 154 ; Lacroix-Triki Magali 155 ; Al Bakir Maise 68 ; Sebastian, Manu M 156 ; van de Vijver Marc 157 ; Balancin, Marcelo Luiz 158 ; Dieci, Maria Vittoria 159 ; Mathieu Marie-Christine 160 ; Rebelatto Marlon C 123 ; Piccart Martine 161 ; Hanna, Matthew G 80 ; Goetz, Matthew P 81 ; Preusser Matthias 129 ; Khojasteh Mehrnoush 162 ; Sanders, Melinda E 163 ; Regan, Meredith M 164 ; Barnes, Michael 165 ; Christie, Michael 166 ; Misialek, Michael 167 ; Ignatiadis Michail 168 ; Mieke, van Bockstal 169 ; Castillo Miluska 170 ; Mohamed, Amgad 171 ; Harbeck Nadia 172 ; Tung, Nadine 173 ; Laudus Nele 174 ; Sirtaine Nicolas 175 ; Burchardi, Nicole 18 ; Ternes Nils 176 ; Radosevic-Robin Nina 177 ; Gluz Oleg 178 ; Grimm, Oliver 88 ; Nuciforo Paolo 179 ; Jank, Paul 180 ; Gonzalez-Ericsson, Paula 181 ; Kirtani Pawan 182 ; Jelinic Petar 131 ; Watson, Peter H 183 ; Savas, Peter 184 ; Francis, Prudence A 185 ; Russell, Prudence A 186 ; Singh, Rajendra 187 ; Kim, Rim S 188 ; Pierce, Robert H 189 ; Hills, Robert 190 ; Leon-Ferre, Roberto 81 ; de Wind Roland 191 ; Shui Ruohong 192 ; Sabine, De Clercq 193 ; Leung, Sam 194 ; Tabbarah Sami 195 ; Souza, Sandra C 196 ; O’Toole Sandra 197 ; Swain, Sandra 198 ; Dudgeon, Sarah 199 ; Willis Scooter 200 ; Ely, Scott 201 ; Seong-Rim, Kim 52 ; Bedri Shahinaz 202 ; Irshad Sheeba 203 ; Shi-Wei, Liu 204 ; Goel Shom 185 ; Hendry Shona 205 ; Bianchi Simonetta 206 ; Bragança Sofia 207 ; Paik Soonmyung 52 ; Wienert Stephan 208 ; Fox, Stephen B 205 ; Luen, Stephen J 19 ; Naber, Stephen 209 ; Schnitt, Stuart J 210 ; Sua Luz F 211 ; Lakhani, Sunil R 212 ; Fineberg, Susan 213 ; Soler, Teresa 214 ; Gevaert, Thomas 215 ; D’Alfonso Timothy 80 ; Tom, John 216 ; Tomohagu, Sugie 217 ; Kurkure Uday 218 ; Bossuyt Veerle 125 ; Manem Venkata 219 ; Cámara, Vincente Peg 220 ; Weida, Tong 221 ; Chen, Weijie 60 ; Yang, Wentao 192 ; Tran, William T 195 ; Wang, Yihong 222 ; Yuan Yinyin 143 ; Allory Yves 223 ; Husain Zaheed 224 ; Bago-Horvath Zsuzsanna 225 

 The Netherlands Cancer Institute, Department of Research IT, Amsterdam, The Netherlands (GRID:grid.430814.a) 
 The Netherlands Cancer Institute, Division of Tumor Biology and Immunology, Amsterdam, The Netherlands (GRID:grid.430814.a) 
 The Netherlands Cancer Institute, Division of Molecular Pathology, Amsterdam, The Netherlands (GRID:grid.430814.a) 
 The Netherlands Cancer Institute, Department of Pathology, Amsterdam, The Netherlands (GRID:grid.430814.a) 
 Ghent University Hospital, Department of Pathology, Ghent, Belgium (GRID:grid.410566.0) (ISNI:0000 0004 0626 3303) 
 The Netherlands Cancer Institute, Department of Biometrics, Amsterdam, The Netherlands (GRID:grid.430814.a) 
 New York University School of Medicine, Department of Medicine, Perlmutter Cancer Center, New York, USA (GRID:grid.137628.9) (ISNI:0000 0004 1936 8753) 
 Weill Cornell Medicine, Department of Radiation Oncology, New York, USA (GRID:grid.5386.8) (ISNI:000000041936877X); Weill Cornell Medicine, Department of Pathology and Laboratory Medicine, New York, USA (GRID:grid.5386.8) (ISNI:000000041936877X) 
 IEO European Institute of Oncology IRCCS, International Breast Cancer Study Group Central Pathology Office, Department of Pathology and Laboratory Medicine, Milan, Italy (GRID:grid.15667.33) (ISNI:0000 0004 1757 0843); University of Milan, Milan, Italy (GRID:grid.4708.b) (ISNI:0000 0004 1757 2822) 
10  University of British Columbia, Department of Pathology and Laboratory Medicine, Genetic Pathology Evaluation Centre, Vancouver, Canada (GRID:grid.17091.3e) (ISNI:0000 0001 2288 9830) 
11  Indiana University Simon Cancer Center, Department of Pathology and Laboratory Medicine, Indianapolis, USA (GRID:grid.257413.6) (ISNI:0000 0001 2287 3919) 
12  Université Paris-Saclay, Service de Biostatistique et d’Epidémiologie, Gustave Roussy, CESP, Université-Paris Sud, Villejuif, France (GRID:grid.460789.4) (ISNI:0000 0004 4910 6535); Université Paris-Saclay, CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Villejuif, France (GRID:grid.460789.4) (ISNI:0000 0004 4910 6535) 
13  M.D. Anderson Cancer Center, Department of Pathology, Houston, USA (GRID:grid.240145.6) (ISNI:0000 0001 2291 4776) 
14  Université Libre de Bruxelles, Breast Cancer Translational Research Laboratory, Institut Jules Bordet, U-CRC, Brussels, Belgium (GRID:grid.4989.c) (ISNI:0000 0001 2348 0746) 
15  Yale School of Medicine, Department of Pathology, New Haven, USA (GRID:grid.47100.32) (ISNI:0000000419368710); Yale University School of Medicine, Department of Medicine, New Haven, USA (GRID:grid.47100.32) (ISNI:0000000419368710) 
16  National Cancer Institute, Laboratory of Pathology, Center for Cancer Research, Bethesda, USA (GRID:grid.48336.3a) (ISNI:0000 0004 1936 8075) 
17  Charité Universitätsmedizin Berlin, Institute of Pathology, Berlin, Germany (GRID:grid.6363.0) (ISNI:0000 0001 2218 4662); Philipps-University Marburg, Institute of Pathology, Marburg, Germany (GRID:grid.10253.35) (ISNI:0000 0004 1936 9756) 
18  German Breast Group, Neu-Isenburg, Germany (GRID:grid.434440.3) (ISNI:0000 0004 0457 2954) 
19  University of Melbourne, Division of Research and Clinical Medicine, Peter MacCallum Cancer Centre, Melbourne, Australia (GRID:grid.1008.9) (ISNI:0000 0001 2179 088X) 
20  Ontario Institute for Cancer Research, Toronto, Canada (GRID:grid.419890.d) (ISNI:0000 0004 0626 690X); IGMM, Edinburgh, UK (GRID:grid.415854.9) (ISNI:0000 0004 0605 7892); Western General Hospital, Edinburgh Cancer Research Centre, Edinburgh, UK (GRID:grid.417068.c) (ISNI:0000 0004 0624 9907) 
21  IRCCS Fondazion - Instituto Nazionale Tumori, Department of Pathology and Laboratory Medicine, Milan, Italy (GRID:grid.417893.0) (ISNI:0000 0001 0807 2568); University of Milan, School of Medicine, Milan, Italy (GRID:grid.4708.b) (ISNI:0000 0004 1757 2822) 
22  Harvard Medical School, Department of Pathology, Brigham and Women’s Hospital, Boston, USA (GRID:grid.38142.3c) (ISNI:000000041936754X) 
23  The Institute of Cancer Research, Clinical Trials and Statistics Unit, Surrey, UK (GRID:grid.18886.3f) (ISNI:0000 0001 1271 4623) 
24  The Institute of Cancer Research, Breast Cancer Now Toby Robins Research Centre, London, UK (GRID:grid.18886.3f) (ISNI:0000 0001 1271 4623) 
25  Vivactiv Ltd, Research and Development, Chesham, UK (GRID:grid.18886.3f) 
26  University of Ottawa, Department of Pathology and Laboratory Medicine, Ottawa, Canada (GRID:grid.28046.38) (ISNI:0000 0001 2182 2255) 
27  University of Melbourne, Division of Research and Clinical Medicine, Peter MacCallum Cancer Centre, Melbourne, Australia (GRID:grid.1008.9) (ISNI:0000 0001 2179 088X); GZA-ZNA Ziekenhuizen, Department of Pathology, Antwerp, Belgium (GRID:grid.428965.4) (ISNI:0000 0004 7536 2436) 
28  The Netherlands Cancer Institute, Division of Tumor Biology and Immunology, Amsterdam, The Netherlands (GRID:grid.430814.a); The Netherlands Cancer Institute, Department of Medical Oncology, Amsterdam, The Netherlands (GRID:grid.430814.a) 
29  The Netherlands Cancer Institute, Division of Molecular Pathology, Amsterdam, The Netherlands (GRID:grid.430814.a); The Netherlands Cancer Institute, Department of Pathology, Amsterdam, The Netherlands (GRID:grid.430814.a) 
30  Department of Oral and Maxillofacial Diseases, Helsinki, Finland (GRID:grid.430814.a) 
31  Department of Pathology, Matsuyama Shimin Hospital, Matsuyama, Japan (GRID:grid.459780.7) (ISNI:0000 0004 1772 4320) 
32  Surgical Oncology, Baylor College of Medicine, Houston, USA (GRID:grid.39382.33) (ISNI:0000 0001 2160 926X) 
33  Roche Diagnostics, Mechelen, Belgium (GRID:grid.39382.33) 
34  Departments of Pathology, Genomic Medicine, Dermatology, and Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, USA (GRID:grid.240145.6) (ISNI:0000 0001 2291 4776) 
35  PhenoPath Laboratories, Seattle, USA (GRID:grid.240145.6) 
36  Research Pathology, Genentech Inc., South San Francisco, USA (GRID:grid.418158.1) (ISNI:0000 0004 0534 4718) 
37  University of Turin/Candiolo Cancer Institute - FPO, IRCCS, Candiolo, Italy (GRID:grid.7605.4) (ISNI:0000 0001 2336 6580) 
38  Case Western Reserve University, Cleveland, USA (GRID:grid.67105.35) (ISNI:0000 0001 2164 3847); Louis Stokes Cleveland Veterans Health Administration Medical Center, Cleveland, USA (GRID:grid.67105.35) 
39  Pulmonary Pathology, New York University Center for Biospecimen Research and Development, New York University, New York, USA (GRID:grid.137628.9) (ISNI:0000 0004 1936 8753) 
40  Department of Pathology, Johns Hopkins Hospital, Baltimore, USA (GRID:grid.411935.b) (ISNI:0000 0001 2192 2723) 
41  Department of Pathology, Istituto Europeo di Oncologia, University of Milan, Milan, Italy (GRID:grid.4708.b) (ISNI:0000 0004 1757 2822) 
42  PathAI, Inc, Cambridge, USA (GRID:grid.479429.5) 
43  Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, USA (GRID:grid.412584.e) (ISNI:0000 0004 0434 9816) 
44  Department of Oncology, IVO, Valencia, Spain (GRID:grid.418082.7) (ISNI:0000 0004 1771 144X) 
45  Cancer Bioinformatics Lab, Cancer Centre at Guy’s Hospital, London, UK (GRID:grid.239826.4) (ISNI:0000 0004 0391 895X); School of Life Sciences and Medicine, King’s College London, London, UK (GRID:grid.13097.3c) (ISNI:0000 0001 2322 6764) 
46  Lund University, Skane University Hospital, Department of Clinical Sciences Lund, Oncology and Pathology, Lund, Sweden (GRID:grid.13097.3c) 
47  Dana Farber Cancer Institute, Boston, USA (GRID:grid.65499.37) (ISNI:0000 0001 2106 9910) 
48  Institut Curie, Paris Sciences Lettres Université, Inserm U934, Department of Pathology, Paris, France (GRID:grid.65499.37) 
49  Department of Surgical Pathology, Zealand University Hospital, Køge, Denmark (GRID:grid.476266.7) 
50  Department of Biomedical Informatics, Emory University, USA (GRID:grid.189967.8) (ISNI:0000 0001 0941 6502) 
51  Departments of Pathology and Oncology, The Johns Hopkins Hospital, Baltimore, USA (GRID:grid.411935.b) (ISNI:0000 0001 2192 2723) 
52  National Surgical Adjuvant Breast and Bowel Project Operations Center/NRG Oncology, Pittsburgh, USA (GRID:grid.21925.3d) (ISNI:0000 0004 1936 9000) 
53  Department of Pathology, Karolinska Institutet, Karolinska, Sweden (GRID:grid.4714.6) (ISNI:0000 0004 1937 0626) 
54  Department of Pathology, New York University Langone Medical Centre, New York, USA (GRID:grid.4714.6) 
55  Department of Pathology and Laboratory Medicine, UNC School of Medicine, Chapel Hill, USA (GRID:grid.10698.36) (ISNI:0000000122483208) 
56  Bioinformatics and Computational Genomics Laboratory, Princess Margaret Cancer Center, Toronto, Canada (GRID:grid.10698.36) 
57  Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia (GRID:grid.1055.1) (ISNI:0000000403978434) 
58  Department of Medicine, University of Melbourne, Parkville, Australia (GRID:grid.1008.9) (ISNI:0000 0001 2179 088X) 
59  Trev & Joyce Deeley Research Centre, British Columbia Cancer Agency, Victoria, Canada (GRID:grid.248762.d) (ISNI:0000 0001 0702 3000) 
60  Division of Imaging, Diagnostics, and Software Reliability (DIDSR), Office of Science and Engineering Laboratories (OSEL), Center for Devices and Radiological Health (CDRH), Rockville, USA (GRID:grid.413579.d) (ISNI:0000 0001 2285 9893) 
61  Department of Research, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru (GRID:grid.419177.d) (ISNI:0000 0004 0644 4024); Department of Research, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru (GRID:grid.419177.d) (ISNI:0000 0004 0644 4024) 
62  Providence Cancer Research Center, Portland, Oregon, USA (GRID:grid.419177.d) 
63  Department of Medical Oncology, Istituto Europeo di Oncologia, Milan, Italy (GRID:grid.15667.33) (ISNI:0000 0004 1757 0843) 
64  Roche Diagnostics, Mechelen, Belgium (GRID:grid.15667.33) 
65  Department of Pathology, AZ Turnhout, Turnhout, Belgium (GRID:grid.476094.8) 
66  Department of Pathology, St Vincent’s University Hospital and University College Dublin, Dublin, Ireland (GRID:grid.7886.1) (ISNI:0000 0001 0768 2743) 
67  Department of Computational and Systems Biology, University of Pittsburgh, Pittsburgh, USA (GRID:grid.21925.3d) (ISNI:0000 0004 1936 9000) 
68  Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, University College London, London, UK (GRID:grid.83440.3b) (ISNI:0000000121901201) 
69  Azienda AUSL, Regional Hospital of Aosta, Aosta, Italy (GRID:grid.83440.3b) 
70  Université Paris-Sud, Institut National de la Santé et de la Recherche Médicale, Villejuif, France (GRID:grid.5842.b) (ISNI:0000 0001 2171 2558); Gustave Roussy, Universite Paris-Saclay, Villejuif, France (GRID:grid.14925.3b) (ISNI:0000 0001 2284 9388) 
71  University Hospital Halle (Saale), Institute of Pathology, Halle, Germany (GRID:grid.461820.9) (ISNI:0000 0004 0390 1701) 
72  Department of Pathology, UCL Cancer Institute, UCL, London, UK (GRID:grid.83440.3b) (ISNI:0000000121901201); University College Hospitals NHS Trust, London, UK (GRID:grid.52996.31) (ISNI:0000 0000 8937 2257) 
73  Department of Pathology, Jules Bordet Institute, Brussels, Belgium (GRID:grid.418119.4) (ISNI:0000 0001 0684 291X) 
74  Department of Clinical Medicine, Macquarie University, Sydney, Australia (GRID:grid.1004.5) (ISNI:0000 0001 2158 5405) 
75  HistoGeneX NV, Antwerp, Belgium and AZ Sint-Maarten Hospital, Mechelen, Belgium (GRID:grid.1004.5) 
76  Oncology Clinical Development, Bristol-Myers Squibb, Princeton, USA (GRID:grid.419971.3) 
77  Institut für Pathologie, UK Hamburg, Germany (GRID:grid.5252.0) (ISNI:0000 0004 1936 973X) 
78  Department of Medicine, Vanderbilt University Medical Centre, Nashville, USA (GRID:grid.412807.8) (ISNI:0000 0004 1936 9916) 
79  Department of Cancer CV, Jacksonville, USA (GRID:grid.412807.8) 
80  Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, USA (GRID:grid.51462.34) (ISNI:0000 0001 2171 9952) 
81  Department of Oncology, Mayo Clinic, Rochester, USA (GRID:grid.66875.3a) (ISNI:0000 0004 0459 167X) 
82  Roche, Tucson, USA (GRID:grid.418158.1) (ISNI:0000 0004 0534 4718) 
83  Department of Pathology, Herlev and Gentofte Hospital, Gentofte, Denmark (GRID:grid.411646.0) (ISNI:0000 0004 0646 7402) 
84  Université Paris-Saclay, Univ. Paris-Sud, Villejuif, France (GRID:grid.5842.b) (ISNI:0000 0001 2171 2558); Service de biostatistique et d’épidémiologie, Gustave Roussy, Villejuif, France (GRID:grid.14925.3b) (ISNI:0000 0001 2284 9388) 
85  Yale School of Medicine, Department of Pathology, New Haven, USA (GRID:grid.47100.32) (ISNI:0000000419368710) 
86  Department of Pathology, Universidad de La Frontera, Temuco, Chile (GRID:grid.412163.3) (ISNI:0000 0001 2287 9552); Departamento de Anatomía Patológica, Universidad de La Frontera, Temuco, Chile (GRID:grid.412163.3) (ISNI:0000 0001 2287 9552) 
87  Tumor Pathology Department, Maria Sklodowska-Curie Memorial Cancer Center, Gliwice, Poland (GRID:grid.418165.f) (ISNI:0000 0004 0540 2543) 
88  Pathology and Tissue Analytics, Roche, Neuherberg, Germany (GRID:grid.424277.0) 
89  Department of Medical Oncology, Gustave Roussy, Villejuif, France (GRID:grid.14925.3b) (ISNI:0000 0001 2284 9388) 
90  Sunnybrook Health Sciences Centre, Toronto, Canada (GRID:grid.413104.3) (ISNI:0000 0000 9743 1587) 
91  Tehran University of Medical Sciences, Tehran, Iran (GRID:grid.411705.6) (ISNI:0000 0001 0166 0922) 
92  Pathology Department, Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD), Madrid, Spain (GRID:grid.5515.4) (ISNI:0000000119578126); GEICAM-Spanish Breast Cancer Research Group, Madrid, Spain (GRID:grid.430580.a) 
93  Translational Research, Montreal, Canada (GRID:grid.430580.a) 
94  Computational Pathology Group, Department of Pathology, Nijmegen, The Netherlands (GRID:grid.430580.a) 
95  Oncology Biomarker Development, Genentech-Roche, Neuherberg, Germany (GRID:grid.430580.a) 
96  Division of Medical Oncology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, USA (GRID:grid.430503.1) (ISNI:0000 0001 0703 675X) 
97  Charité Universitätsmedizin Berlin, Institute of Pathology, Berlin, Germany (GRID:grid.6363.0) (ISNI:0000 0001 2218 4662) 
98  Centre de Lutte Contre le cancer - Centre Jean Perrin, Clermont-Ferrand, France (GRID:grid.418113.e) (ISNI:0000 0004 1795 1689) 
99  Department of Pathology, Hospital de Oncología Maria Curie, Buenos Aires, Argentina (GRID:grid.418113.e) 
100  Directorate of Surgical Pathology, SA Pathology, Adelaide, Australia (GRID:grid.414733.6) (ISNI:0000 0001 2294 430X) 
101  Department of Pathology, GZA-ZNA Ziekenhuizen, Wilrijk, Belgium (GRID:grid.414733.6) 
102  University of Milano, Instituto Europeo di Oncologia, IRCCS, Milano, Italy (GRID:grid.4708.b) (ISNI:0000 0004 1757 2822); Division of Early Drug Development for Innovative Therapy, IEO, European Institute of Oncology IRCCS, Milan, Italy (GRID:grid.15667.33) (ISNI:0000 0004 1757 0843) 
103  Department of Imaging and Pathology, Laboratory of TranslCal Cell & Tissue Research, Leuven, Belgium (GRID:grid.15667.33); KU Leuven- University Hospitals Leuven, Department of Pathology, Leuven, Belgium (GRID:grid.5596.f) (ISNI:0000 0001 0668 7884) 
104  Department of Pathology, University Hospital of Antwerp, Antwerp, Belgium (GRID:grid.411414.5) (ISNI:0000 0004 0626 3418) 
105  Paula I, Breast Cancer Research Program, Vanderbilt University Medical Center, Nashville, USA (GRID:grid.412807.8) (ISNI:0000 0004 1936 9916) 
106  Translational Health Sciences, Department of Cellular Pathology, North Bristol NHS Trust, University of Bristol, Bristol, UK (GRID:grid.5337.2) (ISNI:0000 0004 1936 7603) 
107  Medical Oncology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, USA (GRID:grid.50956.3f) (ISNI:0000 0001 2152 9905) 
108  Helsinki University Central Hospital, Helsinki, Finland (GRID:grid.15485.3d) (ISNI:0000 0000 9950 5666) 
109  Department of Clinical Pathology, Akademiska University Hospital, Uppsala, Sweden (GRID:grid.412354.5) (ISNI:0000 0001 2351 3333) 
110  Department of Pathology, National Taiwan University Hospital, Taipei, Taiwan (GRID:grid.412094.a) (ISNI:0000 0004 0572 7815) 
111  Department of Oncology, National Taiwan University Cancer Center, Taipei, Taiwan (GRID:grid.19188.39) (ISNI:0000 0004 0546 0241); Graduate Institute of Oncology, College of Medicine, National Taiwan University, Taipei, Taiwan (GRID:grid.19188.39) (ISNI:0000 0004 0546 0241) 
112  International Agency for Research on Cancer (IARC), World Health Organization, Lyon, France (GRID:grid.17703.32) (ISNI:0000000405980095) 
113  Department of Pathology, Sanatorio Mater Dei, Buenos Aires, Argentina (GRID:grid.17703.32) 
114  Institute of Pathology, Medical University of Graz, Graz, Austria (GRID:grid.11598.34) (ISNI:0000 0000 8988 2476) 
115  Department of Oncology, National Cancer Centre Singapore, Singapore, Singapore (GRID:grid.410724.4) (ISNI:0000 0004 0620 9745) 
116  Department of Pathology, Brigham and Women’s Hospital, Boston, USA (GRID:grid.62560.37) (ISNI:0000 0004 0378 8294) 
117  Department of Pathology, Netherlands Cancer Institute, Amsterdam, The Netherlands (GRID:grid.430814.a) 
118  PathAI Inc, Cambridge, USA (GRID:grid.479429.5) 
119  Visiopharm A/S, Hørsholm, Denmark (GRID:grid.479429.5); DTU Compute, Department of Applied Mathematics, Technical University of Denmark, Lyngby, Denmark (GRID:grid.5170.3) (ISNI:0000 0001 2181 8870) 
120  Nuffield Department of Population Health, University of Oxford, Oxford, UK (GRID:grid.4991.5) (ISNI:0000 0004 1936 8948); Department of Medical Oncology, University Hospitals Bristol NHS Foundation Trust, Bristol, UK (GRID:grid.410421.2) (ISNI:0000 0004 0380 7336) 
121  Computational Pathology Group, Department of Pathology, Nijmegen, The Netherlands (GRID:grid.410421.2) 
122  R&D UNICANCER, Paris, France (GRID:grid.410421.2) 
123  Translational Sciences, MedImmune, Gaithersberg, USA (GRID:grid.418152.b) 
124  Breast Unit, Champalimaud Clinical Centre, Lisboa, Portugal (GRID:grid.418152.b) 
125  Department of Pathology, Massachusetts General Hospital, Boston, USA (GRID:grid.32224.35) (ISNI:0000 0004 0386 9924) 
126  Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, USA (GRID:grid.66875.3a) (ISNI:0000 0004 0459 167X) 
127  Biomedical Informatics Department, Stony Brook University, Stony Brook, USA (GRID:grid.36425.36) (ISNI:0000 0001 2216 9681) 
128  Department of Oncology and Pathology, Karolinska Institutet and University Hospital, Solna, Sweden (GRID:grid.24381.3c) (ISNI:0000 0000 9241 5705) 
129  Department of Medicine, Clinical Division of Oncology, Comprehensive Cancer Centre Vienna, Medical University of Vienna, Vienna, Austria (GRID:grid.22937.3d) (ISNI:0000 0000 9259 8492) 
130  Leicester Cancer Research Centre, University of Leicester, Leicester, and MRC Toxicology Unit, University of Cambridge, Cambridge, UK (GRID:grid.5335.0) (ISNI:0000000121885934) 
131  Merck & Co., Inc, Kenilworth, USA (GRID:grid.417993.1) (ISNI:0000 0001 2260 0793) 
132  Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, USA (GRID:grid.51462.34) (ISNI:0000 0001 2171 9952); Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, USA (GRID:grid.51462.34) (ISNI:0000 0001 2171 9952) 
133  Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru (GRID:grid.419177.d) (ISNI:0000 0004 0644 4024) 
134  Department of Medicine, Department of Obstetrics and Gynecology and Women’s Health, Albert Einstein Medical Center, Bronx, USA (GRID:grid.419177.d) 
135  GHI Le Raincy-Montfermeil, Chelles, Île-de-France, France (GRID:grid.420138.c) (ISNI:0000 0000 8620 9964) 
136  Department of Pathology, Universidad de La Frontera, Temuco, Chile (GRID:grid.412163.3) (ISNI:0000 0001 2287 9552) 
137  Department of Pathology, Gustave Roussy, Grand Paris, France (GRID:grid.14925.3b) (ISNI:0000 0001 2284 9388) 
138  Departments of Medicine and Cancer Biology, Vanderbilt University Medical Centre, Nashville, USA (GRID:grid.412807.8) (ISNI:0000 0004 1936 9916) 
139  VMscope GmbH, Berlin, Germany (GRID:grid.412807.8) 
140  Department of Pathology, Breast Pathology Section, Northwestern University, Chicago, USA (GRID:grid.16753.36) (ISNI:0000 0001 2299 3507) 
141  Molecular Immunology Unit, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium (GRID:grid.16753.36) 
142  NSABP/NRG Oncology, Pittsburgh, USA (GRID:grid.434440.3) 
143  Division of Molecular Pathology, Centre for Evolution and Cancer, The Institute of Cancer Research, London, UK (GRID:grid.18886.3f) (ISNI:0000 0001 1271 4623) 
144  Cancer Biomarkers Working Group, Faculty of Medicine and Pharmacy, Université Mohamed Premier, Oujda, Morocco (GRID:grid.410890.4) (ISNI:0000 0004 1772 8348) 
145  Yale Cancer Center Genetics, Genomics and Epigenetics Program, Yale School of Medicine, New Haven, USA (GRID:grid.47100.32) (ISNI:0000000419368710) 
146  Pathology Department, Stanford University Medical Centre, Stanford, USA (GRID:grid.47100.32) 
147  Pathology and Tissue Analytics, Roche Innovation Centre Munich, Penzberg, Germany (GRID:grid.47100.32) 
148  Pathology Department, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain (GRID:grid.411142.3) (ISNI:0000 0004 1767 8811); GEICAM-Spanish Breast Cancer Research Group, Madrid, Spain (GRID:grid.430580.a) 
149  Molecular Immunology Unit, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium (GRID:grid.430580.a) 
150  Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, USA (GRID:grid.16753.36) (ISNI:0000 0001 2299 3507) 
151  Center for Pharmacogenomics and Fudan-Zhangjiang, Center for Clinical Genomics School of Life Sciences and Shanghai Cancer Center, Fudan University, Fudan, China (GRID:grid.8547.e) (ISNI:0000 0001 0125 2443) 
152  GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre and Department of Pathology, Maastricht University Medical Centre, Maastricht, The Netherlands (GRID:grid.412966.e) (ISNI:0000 0004 0480 1382) 
153  Oncology Biomarker Development, Genentech-Roche, Neuherberg, Germany (GRID:grid.412966.e) 
154  Biorepository and Tissue Technology Shared Resources, University of California San Diego, San Diego, USA (GRID:grid.266100.3) (ISNI:0000 0001 2107 4242) 
155  Department of Pathology, Gustave Roussy, Villejuif, France (GRID:grid.14925.3b) (ISNI:0000 0001 2284 9388) 
156  Departments of Epigenetics and Molecular Carcinogenesis, The University of Texas MD Anderson Cancer Center, Houston, USA (GRID:grid.240145.6) (ISNI:0000 0001 2291 4776) 
157  Department of Pathology, Academic Medical Center, Amsterdam, The Netherlands (GRID:grid.5650.6) (ISNI:0000000404654431) 
158  Department of Pathology, University of São Paulo, São Paulo, Brazil (GRID:grid.11899.38) (ISNI:0000 0004 1937 0722); Hospital das Clínicas, Sao Paulo, Brasil (GRID:grid.411074.7) (ISNI:0000 0001 2297 2036) 
159  Department of Surgery, Oncology and Gastroenterology, University of Padova, Padua, Italy (GRID:grid.5608.b) (ISNI:0000 0004 1757 3470) 
160  Department of Medical Biology and Pathology, Gustave Roussy Cancer Campus, Villejuif, France (GRID:grid.14925.3b) (ISNI:0000 0001 2284 9388) 
161  Institut Jules Bordet, Universite Libre de Bruxelles, Brussels, Belgium (GRID:grid.418119.4) (ISNI:0000 0001 0684 291X) 
162  Roche Tissue Diagnostics, Digital Pathology, Santa Clara, USA (GRID:grid.22937.3d) 
163  Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Centre, Nashville, USA (GRID:grid.412807.8) (ISNI:0000 0004 1936 9916) 
164  Division of Biostatistics, Dana-Farber Cancer Institute, Boston, USA (GRID:grid.65499.37) (ISNI:0000 0001 2106 9910); Harvard Medical School, Boston, USA (GRID:grid.38142.3c) (ISNI:000000041936754X) 
165  Roche Diagnostics Information Solutions, Belmont, USA (GRID:grid.418158.1) (ISNI:0000 0004 0534 4718) 
166  Department of Anatomical Pathology, Royal Melbourne Hospital, Parkville, Australia (GRID:grid.416153.4) (ISNI:0000 0004 0624 1200) 
167  Vernon Cancer Center, Newton-Wellesley Hospital, Newton, USA (GRID:grid.416176.3) (ISNI:0000 0000 9957 1751) 
168  Department of Medical Oncology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium (GRID:grid.416176.3) 
169  Service de pathologique, Cliniques universitaires Saint-Luc, Bruxelles, Belgique (GRID:grid.48769.34) (ISNI:0000 0004 0461 6320) 
170  Department of Research, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru (GRID:grid.419177.d) (ISNI:0000 0004 0644 4024) 
171  Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, USA (GRID:grid.189967.8) (ISNI:0000 0001 0941 6502) 
172  Breast Center, Dept. OB&GYN and CCC (LMU), University of Munich, Munich, Germany (GRID:grid.5252.0) (ISNI:0000 0004 1936 973X) 
173  Division of Hematology-Oncology, Beth Israel Deaconess Medical Center, Boston, USA (GRID:grid.239395.7) (ISNI:0000 0000 9011 8547) 
174  University of Leuven, Leuven, Belgium (GRID:grid.5596.f) (ISNI:0000 0001 0668 7884) 
175  Department of Pathology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium (GRID:grid.5596.f) 
176  Université Paris-Saclay, Service de Biostatistique et d’Epidémiologie, Gustave Roussy, CESP, Université-Paris Sud, Villejuif, France (GRID:grid.460789.4) (ISNI:0000 0004 4910 6535) 
177  Department of Surgical Pathology and Biopathology, Jean Perrin Comprehensive Cancer Centre, Clermont-Ferrand, France (GRID:grid.460789.4) 
178  Johanniter GmbH - Evangelisches Krankenhaus Bethesda Mönchengladbach, West German Study Group, Mönchengladbach, Germany (GRID:grid.476830.e) 
179  Molecular Oncology Group, Vall d’Hebron Institute of Oncology, Barcelona, Spain (GRID:grid.411083.f) (ISNI:0000 0001 0675 8654) 
180  Department of Pathology, University of Marburg, Marburg, Germany (GRID:grid.10253.35) (ISNI:0000 0004 1936 9756) 
181  Breast Cancer Program, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, USA (GRID:grid.412807.8) (ISNI:0000 0004 1936 9916) 
182  Department of Histopathology, Manipal Hospitals Dwarka, New Delhi, India (GRID:grid.412807.8) 
183  Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada (GRID:grid.17091.3e) (ISNI:0000 0001 2288 9830) 
184  University of Melbourne, Division of Research and Clinical Medicine, Peter MacCallum Cancer Centre, Melbourne, Australia (GRID:grid.1008.9) (ISNI:0000 0001 2179 088X); The Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia (GRID:grid.1008.9) (ISNI:0000 0001 2179 088X) 
185  Peter MacCallum Cancer Centre, Melbourne, Australia (GRID:grid.1055.1) (ISNI:0000000403978434); Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia (GRID:grid.1008.9) (ISNI:0000 0001 2179 088X) 
186  Department of Anatomical Pathology, St Vincent’s Hospital Melbourne, Fitzroy, Australia (GRID:grid.413105.2) (ISNI:0000 0000 8606 2560) 
187  Icahn School of Medicine at Mt. Sinai, New York, USA (GRID:grid.59734.3c) (ISNI:0000 0001 0670 2351) 
188  NRG Oncology/NSABP, Pittsburgh, USA (GRID:grid.59734.3c) 
189  Cancer Immunotherapy Trials Network, Central Laboratory and Program in Immunology, Fred Hutchinson Cancer Research Center, Seattle, USA (GRID:grid.270240.3) (ISNI:0000 0001 2180 1622) 
190  Clinical Trial Service Unit & Epidemiological Studies Unit, University of Oxford, Oxford, UK (GRID:grid.4991.5) (ISNI:0000 0004 1936 8948) 
191  Department of Pathology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium (GRID:grid.66875.3a) 
192  Department of Pathology, Fudan University Cancer Center, Shanghai, China (GRID:grid.8547.e) (ISNI:0000 0001 0125 2443) 
193  Department of Pathology, GZA-ZNA Hospitals, Antwerp, Belgium (GRID:grid.428965.4) (ISNI:0000 0004 7536 2436) 
194  University of British Columbia, Vancouver, Canada (GRID:grid.17091.3e) (ISNI:0000 0001 2288 9830) 
195  Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Research Institute, Toronto, Canada (GRID:grid.17063.33) (ISNI:0000 0001 2157 2938) 
196  Merck Oncology, Kenilworth, USA (GRID:grid.17063.33) 
197  The Cancer Research Program, Garvan Institute of Medical Research, Darlinghurst, Australia (GRID:grid.415306.5) (ISNI:0000 0000 9983 6924) 
198  Georgetown University Medical Center, Washington, USA (GRID:grid.411667.3) (ISNI:0000 0001 2186 0438) 
199  FDA/CDRH/OSEL/Division of Imaging, Diagnostics, and Software Reliability, Silver Spring, USA (GRID:grid.411667.3) 
200  Department of Molecular and Experimental Medicine, Avera Cancer Institute, Sioux Falls, USA (GRID:grid.414118.9) (ISNI:0000 0004 0464 4831) 
201  Translational Medicine, Bristol-Myers Squibb, Princeton, USA (GRID:grid.419971.3) 
202  Anatomic Pathology, Boston, USA (GRID:grid.21925.3d) 
203  Guy’s Hospital, London, UK (GRID:grid.239826.4) (ISNI:0000 0004 0391 895X); King’s College London, London, UK (GRID:grid.13097.3c) (ISNI:0000 0001 2322 6764) 
204  Peking University First Hospital Breast Disease Center, Beijing, China (GRID:grid.411472.5) (ISNI:0000 0004 1764 1621) 
205  Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, Australia (GRID:grid.1055.1) (ISNI:0000000403978434) 
206  Dipartimento di Scienze della Salute (DSS), Firenze, Italy (GRID:grid.1055.1) 
207  Department of Oncology, Champalimaud Clinical Centre, Lisbon, Portugal (GRID:grid.1055.1) 
208  Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Pathology, Berlin, Germany (GRID:grid.21925.3d) 
209  Department of Pathology and Laboratory Medicine, Tufts Medical Center, Boston, USA (GRID:grid.67033.31) (ISNI:0000 0000 8934 4045) 
210  Harvard Medical School, Department of Pathology, Brigham and Women’s Hospital, Boston, USA (GRID:grid.38142.3c) (ISNI:000000041936754X); Dana-Farber Cancer Institute, Boston, USA (GRID:grid.65499.37) (ISNI:0000 0001 2106 9910) 
211  Department of Pathology, Fundación Valle del Lili, Cali, Valle del Cauca, Colombia (GRID:grid.477264.4) 
212  The University of Queensland Centre for Clinical Research and Pathology Queensland, Brisbane, Australia (GRID:grid.1003.2) (ISNI:0000 0000 9320 7537) 
213  Department of Pathology, Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, USA (GRID:grid.240283.f) (ISNI:0000 0001 2152 0791) 
214  Department of Pathology, University Hospital of Bellvitge, Oncobell, IDIBELL, L’Hospitalet del Llobregat, Barcelona, Spain (GRID:grid.240283.f) 
215  Department of Development and Regeneration, Laboratory of Experimental Urology, KU Leuven, Leuven, Belgium (GRID:grid.5596.f) (ISNI:0000 0001 0668 7884) 
216  Department of Medical Oncology, Austin Health, Heidelberg, Australia (GRID:grid.410678.c) 
217  Department of Surgery, Kansai Medical School, Hirakata, Japan (GRID:grid.410783.9) (ISNI:0000 0001 2172 5041) 
218  Roche Tissue Diagnostics, Digital Pathology, Santa Clara, USA (GRID:grid.410783.9) 
219  Bioinformatics and Computational Genomics Laboratory, Princess Margaret Cancer Center, Toronto, Canada (GRID:grid.32224.35) 
220  Pathology Department, H.U. Vall d’Hebron, Barcelona, Spain (GRID:grid.32224.35) 
221  Division of Bioinformatics and Biostatistics, US Food and Drug Administration, Silver Spring, USA (GRID:grid.417587.8) (ISNI:0000 0001 2243 3366) 
222  Department of Pathology and Laboratory Medicine, Rhode Island Hospital and Lifespan Medical Center, Providence, USA (GRID:grid.17063.33) 
223  Université Paris-Est, Créteil, France (GRID:grid.410511.0) (ISNI:0000 0001 2149 7878) 
224  Praava Health, Dhaka, Bangladesh (GRID:grid.410511.0) 
225  Department of Pathology, Medical University of Vienna, Vienna, Austria (GRID:grid.22937.3d) (ISNI:0000 0000 9259 8492) 
Publication year
2020
Publication date
2020
Publisher
Nature Publishing Group
e-ISSN
23744677
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2488351543
Copyright
© The Author(s) 2020. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.