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

Researchers find pathways that uncover insight into development of lung cancer

August 17, 2018
Lung cancer is the leading cause of preventable cancer death. A disease of complex origin, lung cancer is usually considered to result from effects of smoking and from multiple genetic variants. One of these genetic components, ...

Developing an on-off switch for breast cancer treatment

August 17, 2018
T-cells play an important role in the body's immune system, and one of their tasks is to find and destroy infection. However, T-cells struggle to identify solid, cancerous tumors in the body. A current cancer therapy is using ...

Scientists discover new method of diagnosing cancer with malaria protein

August 17, 2018
In a spectacular new study, researchers from the University of Copenhagen have discovered a method of diagnosing a broad range of cancers at their early stages by utilising a particular malaria protein that sticks to cancer ...

Pregnant? Eating broccoli sprouts may reduce child's chances of breast cancer later in life

August 16, 2018
Researchers at the University of Alabama at Birmingham have found that a plant-based diet is more effective in preventing breast cancer later in life for the child if the mother consumed broccoli while pregnant. The 2018 ...

Three scientists share $500,000 prize for work on cancer therapy

August 15, 2018
Tumors once considered untreatable have disappeared and people previously given months to live are surviving for decades thanks to new therapies emerging from the work of three scientists chosen to receive a $500,000 medical ...

PARP inhibitor improves progression-free survival in patients with advanced breast cancers

August 15, 2018
In a randomized, Phase III trial led by researchers at The University of Texas MD Anderson Cancer Center, the PARP inhibitor talazoparib extended progression-free survival (PFS) and improved quality-of-life measures over ...

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.