Precision immunity: Immunoscore and neoadjuvant treatment in bladder cancer

This review details the clinical utility of Immunoscore, measuring the immune response to cancer within the tumor microenvironment, in bladder cancer. Immunoscore was recently introduced into ESMO Clinical Practice Guidelines for gastrointestinal cancer and into the WHO classification of the Digestive System Tumors. In muscle-invasive bladder cancer (MIBC), the standard-of-care treatment is neo-adjuvant chemotherapy and cystectomy. However, only 50% of the patients are still alive at 5 years. The degree of histologic response positively correlated with Immunoscore and patients at lower risk of relapse or death were associated with a high-Immunoscore. Immunoscore is also predicting response to neoadjuvant chemotherapy-based treatment in several indications. This paves the way for the use of Immunoscore in clinical practice not only in gastrointestinal tumors but also in bladder cancer, and beyond.