To evaluate the effectiveness of Immunoscore in predicting outcomes and guiding treatment in colorectal cancer (CRC) compared to traditional TNM staging.
Key Findings:
Immunoscore predicts recurrence and survival more accurately than TNM staging or MMR status alone.
High Immunoscore in stage III colon cancer correlates with improved disease-free and overall survival with adjuvant chemotherapy.
Low Immunoscore patients show similar outcomes regardless of chemotherapy treatment.
Immunoscore-IC can identify metastatic pMMR CRC patients who may benefit from immune checkpoint inhibitors.
Interpretation:
Immunoscore captures underlying immune biology more effectively than MSI testing, suggesting its potential for improved patient stratification and treatment selection.
Limitations:
Limited implementation in clinical practice due to reliance on proprietary platforms and cost.
Technical complexity and need for standardized training hinder widespread use.
Current tests measure only certain immune cells, not the full immune response.
Conclusion:
Immunoscore represents a significant advancement in immune-informed staging and treatment selection for CRC, with potential for integration into clinical practice and guidelines.
