Cancer classification using the Immunoscore: a worldwide task force

By Jérôme Galon, Franck Pagès, F. Marincola, H. Angell, M. Thurin, A. Lugli, I. Zlobec, A. Berger, C. Bifulco, G. Botti and 54 more. Journal of Translational Medicine, 2012

795 citations recorded by the source corpus.

Prediction of clinical outcome in cancer is usually achieved by histopathological evaluation of tissue samples obtained during surgical resection of the primary tumor. Traditional tumor staging (AJCC/UICC-TNM classification) summarizes data on tumor burden (T), presence of cancer cells in draining and regional lymph nodes (N) and evidence for metastases (M). However, it is now recognized that clinical outcome can significantly vary among patients within the same stage. The current classification provides limited prognostic information, and does not predict response to therapy. Recent literature has alluded to the importance of the host immune system in controlling tumor progression. Thus, evidence supports the notion to include immunological biomarkers, implemented as a tool for the prediction of prognosis and response to therapy. Accumulating data, collected from large cohorts of human cancers, has demonstrated the impact of immune-classification, which has a prognostic value that may add to the significance of the AJCC/UICC TNM-classification. It is therefore imperative to begin to incorporate the ‘Immunoscore’ into traditional classification, thus providing an essential prognostic and potentially predictive tool. Introduction of this parameter as a biomarker to classify cancers, as part of routine diagnostic and prognostic assessment of tumors, will facilitate clinical decision-making including rational stratification of patient treatment. Equally, the inherent complexity of quantitative immunohistochemistry, in conjunction with protocol variation across laboratories, analysis of different immune cell types, inconsistent region selection criteria, and variable ways to quantify immune infiltration, all underline the urgent requirement to reach assay harmonization. In an effort to promote the Immunoscore in routine clinical settings, an international task force was initiated. This review represents a follow-up of the announcement of this initiative, and of the J Transl Med. editorial from January 2012. Immunophenotyping of tumors may provide crucial novel prognostic information. The results of this international validation may result in the implementation of the Immunoscore as a new component for the classification of cancer, designated TNM-I (TNM-Immune).

Subfields: Cancer Research, Immunology, Oncology

View Paper: https://www.semanticscholar.org/paper/53190acaa41ccbee613095f98b63680ac91fd88d

How researchers see this paper

The researchers whose trusted networks rank it highest, strongest advocate first. Every researcher gets a different order.

In Cancer Research

1. Bradly G. Wouters
2. Gabriela Bindea
3. Jérôme Galon
4. Bernhard Mlecnik

In Immunology

1. Jérôme Galon
2. Franck Pagès
3. T. Gajewski
4. David Mcilwain
5. K. Odunsi
6. Lieping Chen

In Oncology

1. Jérôme Galon
2. Garry P. Nolan
3. T. Gajewski
4. Lieping Chen

Citations in the corpus

• Towards the introduction of the ‘Immunoscore’ in the classification of malignant tumours (2013, background): “Thus, considering the probable universal character of the immune control of tumours, it is essential for patients to take into account the immune parameter as a prognostic factor and to introduce the Immunoscore as a component of cancer classification [6,7,35,63,64].”
• Direct activation of STING in the tumor microenvironment leads to potent and systemic tumor regression and immunity (2015, background): “Substantial evidence indicates that tumor-infiltrating lymphocytes (TILs) are correlated with favorable prognosis in diverse malignancies (Galon et al., 2012) and predicts a positive clinical outcome in response to several immunotherapy strategies (Postow et al., 2012; Wolchok et al., 2013).”
• Coordinated Cellular Neighborhoods Orchestrate Antitumoral Immunity at the Colorectal Cancer Invasive Front (2019, result): “contrast to prior studies in CRC and other cancers, including lung, breast, ovarian and melanoma, in which relative abundances of these two cell types were correlated with outcome (Fridman et al., 2012; Galon et al., 2014; Galon et al., 2012; Pages et al., 2018).”
• Gene expression markers of Tumor Infiltrating Leukocytes (2016, background): “Immunohistochemistry (IHC) has been shown to be clinically useful [2], but it cannot assay more than a few immune markers without using up excessive tissue.”