Histopathologic-Based Prognostic Factors of Colorectal Cancers Are Associated With the State of the Local Immune Reaction

Abstract

Assessment of CD8(+) cytotoxic T lymphocytes in combined tumor regions provides an indicator of tumor recurrence beyond that predicted by AJCC/UICC-TNM staging.

The Immune Microenvironment of Human Tumors: General Significance and Clinical Impact

“…The fine analysis of the tumoral immune microenvironment in human has started c.a 30 years ago [60], its functional orientation 15 years ago [61,62] has been deeply explored during the last decade [16,32,63] and resulted in the demonstration that immune quantification is more powerful than traditional staging to predict outcome [16,18]. It is still an intense field of research and will develop, as malignant cell characteristics are refined in the context of how they shape their immune microenvironment and how they may be controlled by it.…”

“…An immune gene signature fundamentally based on a high expression of Th1 and cytotoxicity genes [16,52] is also associated with favorable prognosis and could complement the IMMUNOSCORE. It is noteworthy that the clinical impact of the IS is independent of the UICC-TNM classification of the tumors [18].…”

“…Accumulating evidence that high densities of mature T cells, particularly with a Th1 and cytotoxic orientation, in different locations of a primary tumor, correlate with favorable prognosis both in terms of disease-free and overall survival strongly support the fact that a natural immune reaction controls metastatic cells escape and smoothens cancer aggressiveness [14]. It is striking that the immune score is the strongest prognostic factor for survival in patients with colorectal cancer [15][16][17][18]. Whether at a metastatic stage tumors have escaped immunity is still an open question although emerging observations indicate that the metastatic immune microenvironment may still impact cancer evolution [19][20][21].…”

Polyfunctional response by ImmTAC (IMCgp100) redirected CD8+ and CD4+ T cells

“…Additionally, the cytokines and chemokines released by IMCgp100 redirected T cells are strong attractants of a multitude of other immune cells. The density of tumour‐infiltrating lymphocytes has been shown to be predictive of patient survival for a number of different tumours 37, 38, 39, 40…”

Microenvironnement immunitaire et cancer

“…En revanche, lorsque la densité de ces populations immunitaires dans la tumeur est faible, 75 % des patients ont récidivé et seuls 27,5 % ont survécu [24]. De la même manière, l'immunoscore a permis de subdiviser les patients présentant un cancer de stade avancé en des groupes de pronostic distinct et avec des différences majeures de survie [23]. De plus, il a été montré que l'immunoscore a une valeur pronostique supérieure à celle fournie par la classification TNM.…”