Multicenter International Study of the Consensus Immunoscore for the Prediction of Relapse and Survival in Early-Stage Colon Cancer.

Mlecnik, Bernhard; Lugli, Alessandro; Bindea, Gabriela; Marliot, Florence; Bifulco, Carlo; Lee, Jiun-Kae Jack; Zlobec, Inti; Rau, Tilman T; Berger, Martin D; Nagtegaal, Iris D; Vink-Börger, Elisa; Hartmann, Arndt; Geppert, Carol I; Kolwelter, Julie; Merkel, Susanne; Grützmann, Robert; Van den Eynde, Marc; Jouret-Mourin, Anne; Kartheuser, Alex; Léonard, Daniel; ... (2023). Multicenter International Study of the Consensus Immunoscore for the Prediction of Relapse and Survival in Early-Stage Colon Cancer. Cancers, 15(2) MDPI AG 10.3390/cancers15020418

[img]
Preview
Text
cancers-15-00418-v2.pdf - Published Version
Available under License Creative Commons: Attribution (CC-BY).

Download (1MB) | Preview

BACKGROUND

The prognostic value of Immunoscore was evaluated in Stage II/III colon cancer (CC) patients, but it remains unclear in Stage I/II, and in early-stage subgroups at risk. An international Society for Immunotherapy of Cancer (SITC) study evaluated the pre-defined consensus Immunoscore in tumors from 1885 AJCC/UICC-TNM Stage I/II CC patients from Canada/USA (Cohort 1) and Europe/Asia (Cohort 2).

METHODS

Digital-pathology is used to quantify the densities of CD3+ and CD8+ T-lymphocyte in the center of tumor (CT) and the invasive margin (IM). The time to recurrence (TTR) was the primary endpoint. Secondary endpoints were disease-free survival (DFS), overall survival (OS), prognosis in Stage I, Stage II, Stage II-high-risk, and microsatellite-stable (MSS) patients.

RESULTS

High-Immunoscore presented with the lowest risk of recurrence in both cohorts. In Stage I/II, recurrence-free rates at 5 years were 78.4% (95%-CI, 74.4-82.6), 88.1% (95%-CI, 85.7-90.4), 93.4% (95%-CI, 91.1-95.8) in low, intermediate and high Immunoscore, respectively (HR (Hi vs. Lo) = 0.27 (95%-CI, 0.18-0.41); p < 0.0001). In Cox multivariable analysis, the association of Immunoscore to outcome was independent (TTR: HR (Hi vs. Lo) = 0.29, (95%-CI, 0.17-0.50); p < 0.0001) of the patient's gender, T-stage, sidedness, and microsatellite instability-status (MSI). A significant association of Immunoscore with survival was found for Stage II, high-risk Stage II, T4N0 and MSS patients. The Immunoscore also showed significant association with TTR in Stage-I (HR (Hi vs. Lo) = 0.07 (95%-CI, 0.01-0.61); P = 0.016). The Immunoscore had the strongest (69.5%) contribution χ2 for influencing survival. Patients with a high Immunoscore had prolonged TTR in T4N0 tumors even for patients not receiving chemotherapy, and the Immunoscore remained the only significant parameter in multivariable analysis.

CONCLUSION

In early CC, low Immunoscore reliably identifies patients at risk of relapse for whom a more intensive surveillance program or adjuvant treatment should be considered.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Medical Oncology
04 Faculty of Medicine > Service Sector > Institute of Pathology > Clinical Pathology
04 Faculty of Medicine > Service Sector > Institute of Pathology

UniBE Contributor:

Lugli, Alessandro, Zlobec, Inti, Rau, Tilman, Berger, Martin Dave

Subjects:

600 Technology > 610 Medicine & health
500 Science > 570 Life sciences; biology

ISSN:

2072-6694

Publisher:

MDPI AG

Language:

English

Submitter:

Pubmed Import

Date Deposited:

25 Jan 2023 12:38

Last Modified:

08 Mar 2023 23:28

Publisher DOI:

10.3390/cancers15020418

PubMed ID:

36672367

Uncontrolled Keywords:

Immunoscore colon cancer early-stage predictive biomarkers prognosis tumor microenvironment

BORIS DOI:

10.48350/177762

URI:

https://boris.unibe.ch/id/eprint/177762

Actions (login required)

Edit item Edit item
Provide Feedback