Immunoscore: redefining the landscape of colorectal cancer control and care.

Journal: Future oncology (London, England)
Published Date:

Abstract

The Immunoscore (IS), introduced by Jerome Galon in the early 2000s, evaluates immune cell densities within tumors, offering a more accurate prediction of clinical outcomes in colorectal cancer (CRC) compared to the TNM system. Studies have demonstrated that IS enhances the prediction of recurrence, disease-free survival, and overall survival in early-stage CRC, identifying high-risk patients and optimizing treatment decisions. The IS serves as a prognostic tool with high predictive value in guiding immunotherapy, especially immune checkpoint inhibitors (ICIs). Studies show that high IS scores correlate with better response rates to ICI therapy, facilitating personalized treatment. In addition to CRC, the IS has demonstrated utility across various cancers by predicting treatment responses and survival outcomes. Despite its advantages, the IS faces limitations with traditional tumor-infiltrating lymphocyte assessments. Moreover, the IS's application in guiding adjuvant chemotherapy is constrained by cost and limited data. Nonetheless, advancements combining IS with markers like p21 and p16(INK4a) as well as integrating artificial intelligence and digital pathology, enhance prognostic predictions and patient management. Overall, the IS represents a significant advancement in oncology, with ongoing research likely to further enhance its utility across diverse cancer types.

Authors

  • John Zakhour
    Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon.
  • Maria Njeim
    Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon.
  • Rita Haddad
    Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon.
  • Joseph Akiki
    Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon.
  • Clara Njeim
    Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon.
  • Nicolas Nakouzi
    Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon.
  • Michel Rustom
    Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon.
  • Elias Karam
    Département de Médecine Oncologique, Gustave Roussy, Villejuif, France.
  • Carole Kesrouani
    Pathology Department, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon.
  • Joseph Gharios
    Digestive and Endocrine Surgery Department, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon.
  • Hampig Raphael Kourie
    Hematology-Oncology Department, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon.

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