Spatial Distribution of Immune Cells in Tumors*

The goal of immunotherapy is to enhance the ability of the immune system to kill cancer cells. Immunotherapy is more effective and, in general, the prognosis is better, when more immune cells infiltrate the tumor. We describe various techniques we have developed to explore the question of whether the spatial distribution rather than just the density of immune cells in the tumor is important in forecasting whether cancer recurs. We apply our approach to immune cells in images of tumor tissue taken from (triple negative) breast cancer patients. We find that there is a distinct difference in the spatial distribution of immune cells between good clinical outcome (no recurrence of cancer within at least 5 years of diagnosis) and poor clinical outcome (recurrence within 3 years of diagnosis).