Abstract
There is growing evidence that the immune system may prevent the occurrence, growth and metastatic diffusion of colorectal cancer (CRC). The role played by the adaptive immune response at the tumour site is critical in the balance between tumour invasion and defence against cancer. Recent data have shown that the evaluation of this immune response may help to define the prognosis and possibly the treatment of localised CRC as well as metastatic CRC. Tumour infiltrates with T cells (CD3+), cytotoxic T cells (CD8+) and memory T cells (CD45RO+) are the immune parameters most consistently and strongly associated with good clinical outcome in CRC. Several scoring systems have been developed, including the Immunoscore®, based on the immunohistochemical determination with a digital image analysis system of the density of CD3+ and CD8+ lymphocytes in the centre and the invasive margin of the tumour. This review will focus on the different immunoscoring systems developed in CRC, their performance, their limitations and their potential for improving patients' care in the future.
| Original language | English |
|---|---|
| Pages (from-to) | 105-118 |
| Number of pages | 14 |
| Journal | European Journal of Cancer |
| Volume | 140 |
| DOIs | |
| State | Published - Nov 2020 |
| Externally published | Yes |
Bibliographical note
Publisher Copyright:© 2020 Elsevier Ltd
Funding
A prospective validation of the Immunoscore® in clinical practice has been recently published by Pages et al. [16], thanks to an international consortium that analysed 2681 resected stages I–III colon cancers from 14 centres in 13 countries. This study confirmed the very good intra- and inter-observer reproducibility of the Immunoscore® and its powerful prognostic value, with an 8% recurrence rate at 5 years in patients with high Immunoscore® compared with 19% and 32% in cases of intermediate and low Immunoscore®, respectively (HR 0.20, p < 0.0001). In multivariate analysis, the prognostic impact of Immunoscore® on DFS was independent of age, gender, T and N stage, but also of MSI. This prognostic value was maintained in the subgroup of 1434 stage II colon cancers (HR high versus low 0.20; p < 0.0001). Immunoscore® had the highest relative contribution to the risk of recurrence among all clinical–pathological parameters (Table 2). These results support the implementation of the Immunoscore® as a new component of the prognostic classification of CRC. Astrid Lièvre: Personal fees from HalioDX, AAA, Amgen, Bayer, BMS, Celgene, Incyte, Ipsen, Lilly, Merck, Novartis, Pierre Fabre, Roche, Sandoz, Sanofi, Servier; non-financial support from AAA, Amgen, Bayer, Incyte, Ipsen, Merck, Novartis, Pierre Fabre, Pfizer, Roche, Sandoz, Servier, Integragen; grants from Bayer, Lilly, Merck, Novartis
| Funders | Funder number |
|---|---|
| Amgen | |
| Bristol-Myers Squibb | |
| Eli Lilly and Company | |
| Bayer | |
| Merck | |
| Novartis | |
| Roche | |
| Sanofi | |
| Sandoz | |
| Advanced Accelerator Applications | |
| Ministry of Science and Innovation, New Zealand | |
| Servier |
Keywords
- Colorectal cancer
- Immune score
- Immunity
- Prognosis
