International validation of the consensus Immunoscore for the classification of colon cancer: a prognostic and accuracy study

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11110%2F18%3A10376853" target="_blank" >RIV/00216208:11110/18:10376853 - isvavai.cz</a>

Alternative codes found

RIV/00064165:_____/18:10376853

Result on the web

<a href="https://doi.org/10.1016/S0140-6736(18)30789-X" target="_blank" >https://doi.org/10.1016/S0140-6736(18)30789-X</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1016/S0140-6736(18)30789-X" target="_blank" >10.1016/S0140-6736(18)30789-X</a>

Result language

angličtina

Original language name

International validation of the consensus Immunoscore for the classification of colon cancer: a prognostic and accuracy study

Original language description

Background: The estimation of risk of recurrence for patients with colon carcinoma must be improved. A robust immune score quantification is needed to introduce immune parameters into cancer classification. The aim of the study was to assess the prognostic value of total tumour-infiltrating T-cell counts and cytotoxic tumour-infiltrating T-cells counts with the consensus Immunoscore assay in patients with stage I-III colon cancer. Methods: An international consortium of 14 centres in 13 countries, led by the Society for Immunotherapy of Cancer, assessed the Immunoscore assay in patients with TNM stage I-III colon cancer. Patients were randomly assigned to a training set, an internal validation set, or an external validation set. Paraffin sections of the colon tumour and invasive margin from each patient were processed by immunohistochemistry, and the densities of CD3+ and cytotoxic CD8+ T cells in the tumour and in the invasive margin were quantified by digital pathology. An Immunoscore for each patient was derived from the mean of four density percentiles. The primary endpoint was to evaluate the prognostic value of the Immunoscore for time to recurrence, defined as time from surgery to disease recurrence. Stratified multivariable Cox models were used to assess the associations between Immunoscore and outcomes, adjusting for potential confounders. Harrell&apos;s C-statistics was used to assess model performance. Findings: Tissue samples from 3539 patients were processed, and samples from 2681 patients were included in the analyses after quality controls (700 patients in the training set, 636 patients in the internal validation set, and 1345 patients in the external validation set). The Immunoscore assay showed a high level of reproducibility between observers and centres (r=0.97 for colon tumour; r=0.97 for invasive margin; p&lt;0.0001). In the training set, patients with a high Immunoscore had the lowest risk of recurrence at 5 years (14 [8%] patients with a high Immunoscore vs 65 (19%) patients with an intermediate Immunoscore vs 51 (32%) patients with a low Immunoscore; hazard ratio [HR] for high vs low Immunoscore 0.20, 95% CI 0.10-0.38; p&lt;0.0001). The findings were confirmed in the two validation sets (n=1981). In the stratified Cox multivariable analysis, the Immunoscore association with time to recurrence was independent of patient age, sex, T stage, N stage, microsatellite instability, and existing prognostic factors (p&lt;0.0001). Of 1434 patients with stage II cancer, the difference in risk of recurrence at 5 years was significant (HR for high vs low Immunoscore 0.33, 95% CI 0.21-0.52; p&lt;0.0001), including in Cox multivariable analysis (p&lt;0.0001). Immunoscore had the highest relative contribution to the risk of all clinical parameters, including the American Joint Committee on Cancer and Union for International Cancer Control TNM classification system. Interpretation: The Immunoscore provides a reliable estimate of the risk of recurrence in patients with colon cancer. These results support the implementation of the consensus Immunoscore as a new component of a TNM-Immune classification of cancer.

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

—

OECD FORD branch

30204 - Oncology

Project

<a href="/en/project/NV15-28188A" target="_blank" >NV15-28188A: Monitoring Cancer Microenvironment and Immune response in Adjudicating the Prognosis and therapy response in Patients with solid tumors</a><br>

Continuities

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Publication year

2018

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

The Lancet

ISSN

0140-6736

e-ISSN

—

Volume of the periodical

391

Issue of the periodical within the volume

10135

Country of publishing house

GB - UNITED KINGDOM

Number of pages

12

Pages from-to

2128-2139

UT code for WoS article

000433257200028

EID of the result in the Scopus database

2-s2.0-85046846915