The Immunoscore assay can assess the risk of disease recurrence in Asian patients with early-stage colon cancer and may be used together with TNM classification to guide clinical decision-making, according to findings presented at the European Society for Medical Oncology (ESMO) Asia Virtual Congress 2020 (Abstract 790).
Researchers reported how Immunoscore, an in vitro diagnostic test, may be used to predict the risk of disease relapse in early‐stage colon cancer by measuring the patient’s immune response at the tumor site. They explained that the risk‐assessment tool has been shown to provide independent prognostic value that is superior to the usual risk parameters and is intended for use as an adjunct to the TNM classification for clinical decision.
Study Details
The team conducted this study to evaluate the clinical performance of Immunoscore in an Asian population using data from the Society for Immunotherapy of Cancer (SITC)-led validation study published by Pagès et al in The Lancet, wherein 423 patients of the 2,681 eligible patients with stage I to III disease enrolled in the international Immunoscore study were recruited from four expert centers. Specifically, 330 patients were enrolled from Japan, 35 from China, and 58 from India.
The investigators compared the time to recurrence according to Immunoscore categories. Patient classification by Immunoscore was done using predefined cut-offs: Immunoscore low (0–1) and Immunoscore high (2–4).
Cohort Results
In the Asian cohort, 158 (37%) patients were categorized as Immunoscore low and 266 (63%) were categorized as Immunoscore high.
At 5 years, 86.9% (95% confidence interval [CI] = 82.7%–91.4%) of Immunoscore high patients were event-free compared to 77% (95% CI 70.5%–84.1%) of Immunoscore low patients (hazard ratio [HR] = 0.52, 95% CI = 0.32–0.86, P = .0085).
Furthermore, with model adjustments including Immunoscore, age, sex, T stage, N stage, sidedness, and microsatellite instability, and stratification by center, Immunoscore maintained this association (HR = 0.45, 95% CI = 0.22–0.91, P = .027). When stratified according to the five Immunoscore categories (high to low), the 5-year time to recurrence rates were 100%, 96%, 84%, 80%, and 73.5% for IS4, IS3, IS2, IS1, and IS0, respectively.
The authors noted that these results were similar to those found in European and North American patients. They further concluded that Immunoscore is a strong prognostic indicator of the risk of recurrence in patients with stage I to III colon cancer who receive standard-of-care treatment in real-life clinical practice in Asia and suggested that this first standardized immune-based assay risk assessment tool can be used reliably to guide clinical decisions according to each patient’s information.
Disclosure: This study was funded by the French National Institute of Health and Medical Research (INSERM), the LabEx Immuno-oncology, the Transcan ERAnet Immunoscore European project, Association pour la Recherche contre le Cancer, CARPEM, AP-HP, Institut National du Cancer, Italian Association for Cancer Research, national grants, and SITC. For full disclosures of the study authors, visit oncologypro.esmo.org.
