To synthesize current evidence on the Immunoscore (IS) and its application across various solid tumors, emphasizing its prognostic value and addressing methodological challenges in comparison to traditional staging systems.
Key Findings:
High IS scores correlate with improved survival across various solid tumors, including non-small-cell lung cancer and melanoma.
IS provides a biologically grounded framework that enhances risk stratification beyond traditional TNM staging.
Methodological variability and lack of external validation limit the comparability and reproducibility of IS studies.
Interpretation:
While the IS and related immune classifiers show promise in predicting cancer outcomes, their clinical implementation is hindered by methodological inconsistencies and the complexity of the tumor immune microenvironment, yet they hold potential for improving patient stratification.
Limitations:
Inter-study variability affects comparability and reproducibility, impacting clinical decision-making.
Retrospective designs and single-centre cohorts limit the strength of evidence, necessitating larger, multi-centre studies.
Potential overfitting in computational models complicates interpretation and application in diverse clinical settings.
Conclusion:
The IS represents a significant advancement in integrating immune contexture into cancer prognosis, but requires further validation and harmonization for widespread clinical use.
