Immunoscore—a test to improve the care and treatment of colon cancer

June 8, 2018, Institut National de la Sante et de la Recherche Medicale

With Immunoscore, a test devised by a team of researchers from Inserm and Université Paris Descartes and doctors from the Paris AP-HP hospitals, disease progression in patients with colon cancer can now be defined more accurately. According to an international study conducted in more than 2,500 patients, Immunoscore has proved effective in predicting which patients are at high risk of tumor recurrence and, as such, would benefit from intensified treatment following surgery. These results have been published in The Lancet.

The seriousness of is essentially estimated according to the extent to which it has spread within the colon and the presence of metastasis. This estimation of the aggressiveness of the cancer and its risk of recurrence following treatment must, however, be improved.

For decades, it has been thought that the immune reaction developed by the patient against his or her cancer has a beneficial influence. Researchers from Inserm and doctors from the Paris AP-HP hospitals have demonstrated in recent years that infiltration of the cancerous tumor by immune cells is a good indication of the way in which colorectal cancer might develop, thereby representing a potential prognostic tool. The immune cell populations that provide the most information on disease progression were identified and the method of evaluating these populations optimized.

This method has led to the creation of an immunological test, applicable in clinical practice, called Immunoscore. It works by quantifying the density of two types of immune cells in the tumor and its invasive margin: total T-cells (CD3+) and killer T-cells (cytotoxic CD8+).

The objective of this international study, published in The Lancet, was to evaluate the prognostic value of Immunoscore in with colon cancer on a very large scale. An international consortium of 14 immunology and pathology centers in 13 countries contributed to the study. A total of 2,681 patients from these centers were included in this analysis. The prognostic performance of Immunoscore, in which patients are classified into three groups (high, intermediate and low), was evaluated on the basis of (evaluated during the five years following the surgery) and survival. The statistical analyses were all performed by a group of external biostatisticians from the Mayo Clinic in the U.S. The results show that patients with a high Immunoscore present the lowest recurrence risk and prolonged survival.

In the test group comprising 700 patients, only 8 percent of those with a high score presented a recurrence after 5 years. However, the recurrence rate increased significantly in patients with intermediate and low scores, reaching 19 percent and 32 percent, respectively. These findings were confirmed in the two other patient groups analyzed, representing 1,981 patients. Furthermore, Immunoscore had a stronger bearing on patient survival than the tumor criteria currently used to guide therapy.

These findings show that Immunoscore provides an accurate and reliable estimation of recurrence risk in patients with colon cancer. The researchers consider that these results support the use of Immunoscore as a new component in the classification of cancer, in which risk is used to improve individual patient treatment strategies, particularly the modulation of chemotherapy.

In view of the highly positive results of this test in colon cancer, researchers are currently evaluating Immunoscore in other types of cancer and are studying its ability to predict patient response to the immunotherapies currently revolutionizing the treatment of .

Explore further: Specific immune cells predict bowel cancer outcomes

More information: Franck Pagès et al, International validation of the consensus Immunoscore for the classification of colon cancer: a prognostic and accuracy study, The Lancet (2018). DOI: 10.1016/S0140-6736(18)30789-X

Related Stories

Specific immune cells predict bowel cancer outcomes

March 6, 2017
A pilot study by University of Otago researchers suggests that people with colorectal cancer that have a certain type of immune cell in their tumour may have increased survival rates.

Normalized post-op CEA may help predict colon cancer prognosis

December 26, 2017
(HealthDay)—Colon cancer patients with elevated preoperative carcinoembryonic antigen (CEA) levels that normalize after resection are not at increased risk for poor prognosis, according to a study published online Dec. ...

Underused cancer test could improve treatment for thousands

June 21, 2017
A simple blood test could improve treatment for more than 1 in 6 stage 2 colon cancer patients, suggests new Mayo Clinic research. The researchers also discovered that many patients who could benefit from the test likely ...

Helping to stop colorectal cancer by identifying metastasis chances early

March 15, 2016
Colorectal cancer, one of the most commonly diagnosed cancers in the United States, is not a commonly discussed disease. Often symptomless in early stages, the cancer is more difficult to treat as it progresses, requiring ...

Recommended for you

Study suggests well-known growth suppressor actually fuels lethal brain cancers

June 18, 2018
Scientists report finding a potentially promising treatment target for aggressive and deadly high-grade brain cancers like glioblastoma. But they also say the current lack of a drug that hits the molecular target keeps it ...

Targeting the engine room of the cancer cell

June 18, 2018
Researchers at Columbia University Irving Medical Center (CUIMC) have developed a highly innovative computational framework that can support personalized cancer treatment by matching individual tumors with the drugs or drug ...

Genomics offers new treatment options for infants with range of soft tissue tumors

June 18, 2018
The genetic causes of a group of related infant cancers have been discovered by scientists at the Wellcome Sanger Institute, the University of Wuerzburg and their collaborators. Whole genome sequencing of tumours revealed ...

Researchers create novel combination as potential therapy for high-risk neuroblastoma

June 18, 2018
Researchers at VCU Massey Cancer Center in Richmond, Virginia, have identified a promising target to reverse the development of high-risk neuroblastoma and potentially inform the creation of novel combination therapies for ...

Standard myelofibrosis drug can awaken 'dormant' lymphoma

June 18, 2018
Most patients with myelofibrosis, a rare chronic disorder of the haematopoietic cells of the bone marrow, benefit from drugs from the JAK2 inhibitor class: symptoms are relieved, survival extended and general quality-of-life ...

Breast cancer researcher warns against online genetic tests

June 18, 2018
We have never been so fascinated by the secrets inside our cells.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.