Clinical Performance of the Consensus Immunoscore in Colon Cancer in the Asian Population from the Multicenter International SITC Study
Authors: Mlecnik Bernhard , Torigoe Toshihiko , Bindea Gabriela , Popivanova Boryana , Xu Mingli , Fujita Tomonobu , Hazama Shoichi , Suzuki Nobuaki , Nagano Hiroaki , Okuno Kiyotaka , Hirohashi Yoshihiko , Furuhata Tomohisa , Takemasa Ichiro , Patel Prabhudas , Vora Hemangini , Shah Birva , Patel Jayendrakumar B. , Rajvik Kruti N. , Pandya Shashank J. , Shukla Shilin N. , Wang Yili , Zhang Guanjun , Yoshino Takayuki , Taniguchi Hiroya , Bifulco Carlo , Lugli Alessandro , Lee Jiun-Kae Jack , Zlobec Inti , Rau Tilman T. , Berger Martin D. , Nagtegaal Iris D. , Vink-Börger Elisa , Hartmann Arndt , Geppert Carol I. , Kolwelter Julie , Merkel Susanne , Grützmann Robert , Van den Eynde Marc , Jouret-Mourin Anne , Kartheuser Alex , Léonard Daniel , Remue Christophe , Wang Julia , Bavi Prashant , Roehrl Michael H. A. , Ohashi Pamela S. , Nguyen Linh T. , Han SeongJun , MacGregor Heather L. , Hafezi-Bakhtiari Sara , Wouters Bradly G. , Masucci Giuseppe V. , Andersson Emilia , Zavadova Eva , Vocka Michal , Spacek Jan , Petruzelka Lubos , Konopasek Bohuslav , Dundr Pavel , Skalova Helena , Nemejcova Kristyna , Botti Gerardo , Tatangelo Fabiana , Delrio Paolo , Ciliberto Gennaro , Maio Michele , Laghi Luigi , Grizzi Fabio , Marliot Florence , Fredriksen Tessa , Buttard Bénédicte , Lafontaine Lucie , Maby Pauline , Majdi Amine , Hijazi Assia , El Sissy Carine , Kirilovsky Amos , Berger Anne , Lagorce Christine , Paustian Christopher , Ballesteros-Merino Carmen , Dijkstra Jeroen , Van de Water Carlijn , van Lent-van Vliet Shannon , Knijn Nikki , Mușină Ana-Maria , Scripcariu Dragos-Viorel , Marincola Francesco M. , Ascierto Paolo A. , Fox Bernard A. , Pagès Franck , Kawakami Yutaka , Galon Jérôme 
Published: September 2022

BACKGROUND: In this study, we evaluated the prognostic value of Immunoscore in patients with stage I–III colon cancer (CC) in the Asian population. These patients were originally included in an international study led by the Society for Immunotherapy of Cancer (SITC) on 2681 patients with AJCC/UICC-TNM stages I–III CC. METHODS: CD3+ and cytotoxic CD8+ T-lymphocyte densities were quantified in the tumor and invasive margin by digital pathology. The association of Immunoscore with prognosis was evaluated for time to recurrence (TTR), disease-free survival (DFS), and overall survival (OS). RESULTS: Immunoscore stratified Asian patients (n = 423) into different risk categories and was not impacted by age. Recurrence-free rates at 3 years were 78.5%, 85.2%, and 98.3% for a Low, Intermediate, and High Immunoscore, respectively (HR[Low-vs-High] = 7.26 (95% CI 1.75−30.19); p = 0.0064). A High Immunoscore showed a significant association with prolonged TTR, OS, and DFS (p < 0.05). In Cox multivariable analysis stratified by center, Immunoscore association with TTR was independent (HR[Low-vs-Int+High] = 2.22 (95% CI 1.10–4.55) p = 0.0269) of the patient’s gender, T-stage, N-stage, sidedness, and MSI status. A significant association of a High Immunoscore with prolonged TTR was also found among MSS (HR[Low-vs-Int+High] = 4.58 (95% CI 2.27−9.23); p ≤ 0.0001), stage II (HR[Low-vs-Int+High] = 2.72 (95% CI 1.35−5.51); p = 0.0052), low-risk stage-II (HR[Low-vs-Int+High] = 2.62 (95% CI 1.21−5.68); p = 0.0146), and high-risk stage II patients (HR[Low-vs-Int+High] = 3.11 (95% CI 1.39−6.91); p = 0.0055). CONCLUSION: A High Immunoscore is significantly associated with the prolonged survival of CC patients within the Asian population.