Top Line: There is limited data to guide the selection of patients with rectal cancer for a watch and wait approach following neoadjuvant chemotherapy and radiation.
The Study: A few years back, we learned about the Immunoscore, which quantifies immune infiltration of colorectal tumors. CD3 and CD8 IHC is performed on tumor specimens, and digital images are analyzed to determine the density of intratumoral CD3 and CD8 cells. A low immunoscore was 0-25%, intermediate was 26-70%, and high was >70%. In this study, Immunoscore was performed on initial biopsy specimens of 249 patients who had a clinical CR to neoadjuvant therapy and were managed with a W&W approach. 30.9% had a low score, 55% an intermediate score, and 14.1% a high score. Over a follow up period of 5 years, 23.3% had local recurrence, 6% had distant recurrence, and 2.8% had both. The study found that Immunoscore was independently associated with time to recurrence and disease free survival. Freedom from recurrence was 91.3% for those with a high score compared to 62.5% for an intermediate score and 53.1% for a low score.
TBL: Immunoscore is a predictive biomarker for recurrence in patients with rectal cancer who are managed with W&W after a clinical complete response to neoadjuvant therapy. | El Sissy, J Clin Oncol 2023
The Study: A few years back, we learned about the Immunoscore, which quantifies immune infiltration of colorectal tumors. CD3 and CD8 IHC is performed on tumor specimens, and digital images are analyzed to determine the density of intratumoral CD3 and CD8 cells. A low immunoscore was 0-25%, intermediate was 26-70%, and high was >70%. In this study, Immunoscore was performed on initial biopsy specimens of 249 patients who had a clinical CR to neoadjuvant therapy and were managed with a W&W approach. 30.9% had a low score, 55% an intermediate score, and 14.1% a high score. Over a follow up period of 5 years, 23.3% had local recurrence, 6% had distant recurrence, and 2.8% had both. The study found that Immunoscore was independently associated with time to recurrence and disease free survival. Freedom from recurrence was 91.3% for those with a high score compared to 62.5% for an intermediate score and 53.1% for a low score.
TBL: Immunoscore is a predictive biomarker for recurrence in patients with rectal cancer who are managed with W&W after a clinical complete response to neoadjuvant therapy. | El Sissy, J Clin Oncol 2023