Immunoscore and its introduction in clinical practice
Jérôme Galon1,2, Anastasia Lanzi3,4
1Laboratory of Integrative Cancer Immunology, Equipe Labellisée Ligue Contre le Cancer, French National Institute of Health and Medical Research (INSERM), Sorbonne University, Paris, France - jerome.galon@crc.jussieu.fr.
Summary
The Immunoscore, an immune-based assay, offers superior prognostic value for colorectal cancer (CRC) patients compared to the TNM system. This immune-based classification can guide treatment decisions and predict chemotherapy benefits.
Area of Science:
- Oncology
- Immunology
- Digital Pathology
Background:
- Current cancer classification relies on tumor intrinsic factors (TNM system).
- No established immune-based cancer classification exists.
- Tumor immune contexture significantly impacts colorectal cancer (CRC) patient outcomes.
Purpose of the Study:
- To develop and validate an immune-based assay for cancer classification.
- To assess the prognostic and predictive value of the Immunoscore in CRC patients.
Main Methods:
- Developed the Immunoscore assay using immunohistochemistry and digital pathology.
- Quantified CD3 and CD8 T cell subsets in tumor core and invasive margin.
- Conducted international studies on stage I-III, II-IV colon cancer patients.
Main Results:
- Immunoscore demonstrated superior and independent prognostic value compared to TNM in stage I-III colon cancer.
- Validated prognostic value across stage II-IV CRC.
- Showed predictive value for adjuvant chemotherapy in stage III colon cancer.
- Enabled classification of tumors into hot and cold immune categories.
Conclusions:
- Immunoscore is the first validated immune-based scoring system for cancer.
- Immunoscore can improve patient stratification and guide treatment decisions, including chemotherapy selection.
- This immune-based approach offers a new paradigm for cancer classification and management.
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