Rational bases for the use of the Immunoscore in routine clinical settings as a prognostic and predictive biomarker in cancer patients.
The American Joint Committee on Cancer/Union Internationale Contre le Cancer (AJCC/UICC) tumor, nodes, metastasis (TNM) classification system based on tumor features is used for prognosis estimation and treatment recommendations in most cancers. However, the clinical outcome can vary significantly among patients within the same tumor stage and TNM classification does not predict response to therapy. Therefore, many efforts have been focused on the identification of new markers. Multiple tumor cell-based approaches have been proposed but very few have been translated into the clinic. The recent demonstration of the essential role of the immune system in tumor progression has allowed great advances in the understanding of this complex disease and in the design of novel therapies. The analysis of the immune infiltrate by imaging techniques in large patient cohorts highlighted the prognostic impact of the in situ immune cell infiltrate in tumors. Moreover, the characterization of the immune infiltrates (e.g. type, density, distribution within the tumor, phenotype, activation status) in patients treated with checkpoint-blockade strategies could provide information to predict the disease outcome. In colorectal cancer, we have developed a prognostic score ('Immunoscore') that takes into account the distribution of the density of both CD3(+) lymphocytes and CD8(+) cytotoxic T cells in the tumor core and the invasive margin that could outperform TNM staging. Currently, an international retrospective study is under way to validate the Immunoscore prognostic performance in patients with colon cancer. The use of Immunoscore in clinical practice could improve the patients' prognostic assessment and therapeutic management.
Laboratory of Integrative Cancer Immunology, INSERM UMRS1138, Cordeliers Research Center, 15 Rue de l'Ecole de Medecine, 75006 Paris, France University Paris Descartes, 45 Rue Saints Pères, 75006 Paris, France Centre de Recherche des Cordeliers, University Pierre et Marie Curie Paris 6, 15 Rue de l'Ecole de Medecine, 75006 Paris, France Immunomonitoring Platform, Laboratory of Immunology, Georges Pompidou European Hospital, 20-40 Rue Leblanc, 75015 Paris, France.
Amos
A
Kirilovsky
Laboratory of Integrative Cancer Immunology, INSERM UMRS1138, Cordeliers Research Center, 15 Rue de l'Ecole de Medecine, 75006 Paris, France University Paris Descartes, 45 Rue Saints Pères, 75006 Paris, France Centre de Recherche des Cordeliers, University Pierre et Marie Curie Paris 6, 15 Rue de l'Ecole de Medecine, 75006 Paris, France Immunomonitoring Platform, Laboratory of Immunology, Georges Pompidou European Hospital, 20-40 Rue Leblanc, 75015 Paris, France.
Florence
F
Marliot
Laboratory of Integrative Cancer Immunology, INSERM UMRS1138, Cordeliers Research Center, 15 Rue de l'Ecole de Medecine, 75006 Paris, France University Paris Descartes, 45 Rue Saints Pères, 75006 Paris, France Centre de Recherche des Cordeliers, University Pierre et Marie Curie Paris 6, 15 Rue de l'Ecole de Medecine, 75006 Paris, France Immunomonitoring Platform, Laboratory of Immunology, Georges Pompidou European Hospital, 20-40 Rue Leblanc, 75015 Paris, France.
Carine
C
El Sissy
Laboratory of Integrative Cancer Immunology, INSERM UMRS1138, Cordeliers Research Center, 15 Rue de l'Ecole de Medecine, 75006 Paris, France Immunomonitoring Platform, Laboratory of Immunology, Georges Pompidou European Hospital, 20-40 Rue Leblanc, 75015 Paris, France.
Nacilla
N
Haicheur
Laboratory of Integrative Cancer Immunology, INSERM UMRS1138, Cordeliers Research Center, 15 Rue de l'Ecole de Medecine, 75006 Paris, France University Paris Descartes, 45 Rue Saints Pères, 75006 Paris, France Centre de Recherche des Cordeliers, University Pierre et Marie Curie Paris 6, 15 Rue de l'Ecole de Medecine, 75006 Paris, France.
Jérôme
J
Galon
Laboratory of Integrative Cancer Immunology, INSERM UMRS1138, Cordeliers Research Center, 15 Rue de l'Ecole de Medecine, 75006 Paris, France University Paris Descartes, 45 Rue Saints Pères, 75006 Paris, France Centre de Recherche des Cordeliers, University Pierre et Marie Curie Paris 6, 15 Rue de l'Ecole de Medecine, 75006 Paris, France Immunomonitoring Platform, Laboratory of Immunology, Georges Pompidou European Hospital, 20-40 Rue Leblanc, 75015 Paris, France franck.pages@aphp.fr.
Franck
F
Pagès
D017252:CD3 Complex / Q000378:metabolism; D016827:CD8 Antigens / Q000378:metabolism; D006801:Humans; D008213:Lymphocyte Activation; D016246:Lymphocytes, Tumor-Infiltrating / Q000276:immunology*; D015166:Monitoring, Immunologic / Q000379:methods*; D009367:Neoplasm Staging; D009369:Neoplasms / Q000145:classification / Q000175:diagnosis*; D017410:Practice Guidelines as Topic; D011237:Predictive Value of Tests; D011379:Prognosis; D013602:T-Lymphocytes, Cytotoxic / Q000276:immunology*
D017252:CD3 Complex; D016827:CD8 Antigens
T cells; colorectal cancer; immune response; lymphocyte; tumor microenvironment