A diagnostic biopsy-adapted immunoscore predicts response to neoadjuvant treatment and selects patients with rectal cancer eligible for a watch-and-wait strategy

Clinical Cancer Research : an Official Journal of the American Association for Cancer Research
Carine El SissyFranck Pagès

Abstract

No biomarker to personalize treatment in locally advanced rectal cancer (LARC) is currently available. We assessed in LARC whether a diagnostic biopsy-adapted Immunoscore (ISB) could predict response to neoadjuvant treatment (nT) and better define patients eligible to an organ preservation strategy ("Watch-and-Wait"). Biopsies from two independent cohorts (n1=131, n2=118) of patients with LARC treated with nT followed by radical surgery, were immunostained for CD3+ and CD8+ T cells and quantified by digital pathology to determine ISB. The expression of immune-related genes post-nT was investigated (n=64 patients). Results were correlated with response to nT and disease-free survival (DFS). The ISB prognostic performance was further assessed in a multicentric cohort (n=73 patients) treated by Watch-and-Wait. ISB positively correlated with the degree of histologic response (P<0.001) and gene expression levels for Th1 orientation and cytotoxic immune response, post-nT (P=0.006). ISB High identified patients at lower risk of relapse or death compared to ISB Low (HR=0.21, 95% CI=0.06 to 0.78; P=0.009). Prognostic performance of ISB for DFS was confirmed in a validation cohort. ISB was an independent parameter, more informative than ...Continue Reading

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Citations

Jan 19, 2021·Oncoimmunology·Marc Van den EyndeJérôme Galon
Mar 5, 2021·Oncoimmunology·Elise F NassifJérôme Galon
May 29, 2021·The Lancet Oncology·Robert Glynne-Jones, Stuart Glynne-Jones
Jun 7, 2021·Seminars in Radiation Oncology·Stanley GutiontovRalph Weichselbaum

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