Skip to main content
Log in

Immunoscore®: A Diagnostic Assay for Clinical Management of Colon Cancer

  • Adis Diagnostic Profile
  • Published:
Molecular Diagnosis & Therapy Aims and scope Submit manuscript

Abstract

Immunoscore® is an in vitro diagnostic assay that is designed to predict the risk of relapse in patients with early-stage colon cancer, thus helping to guide treatment strategies. Immunoscore has CE-IVD status in the EU, is CLIA certified in the USA, and is commercially available in many other countries worldwide. It is designed to be used in conjunction with TNM staging. Immunoscore uses digital images of tumour samples and advanced software to quantify the densities of CD3+ and CD8+ lymphocytes in defined regions of the tumour (i.e. core tumour and the invasive margin). A risk score is calculated, with a lower Immunoscore (i.e. lower densities) corresponding to a higher risk of recurrence. In an international, retrospective, validation study led by the Society for Immunotherapy of Cancer (SITC), Immunoscore was found to be robust, reproducible, quantitative and standardized, providing a reliable estimate of the risk of recurrence. The clinical utility of Immunoscore has been validated in the SITC-led study and in several supportive studies in which Immunoscore predicted survival, optimal treatment duration and relapse in patients with colon cancer.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. World Cancer Research Fund. Colorectal cancer statistics. 2018. https://www.wcrf.org. Accessed 17 Feb 2020.

  2. Guraya SY. Pattern, stage, and time of recurrent colorectal cancer after curative surgery. Clin Colorectal Cancer. 2019;18(2):e223–8.

    Article  Google Scholar 

  3. Pages F, Kirilovsky A, Mlecnik B, et al. In situ cytotoxic and memory T cells predict outcome in patients with early-stage colorectal cancer. J Clin Oncol. 2009;27(35):5944–51.

    Article  CAS  Google Scholar 

  4. Varghese A. Chemotherapy for stage II colon cancer. Clin Colon Rectal Surg. 2015;28(4):256–61.

    Article  Google Scholar 

  5. Kirilovsky A, Marliot F, El Sissy C, et al. Rational bases for the use of the Immunoscore in routine clinical settings as a prognostic and predictive biomarker in cancer patients. Int Immunol. 2016;28(8):373–82.

    Article  CAS  Google Scholar 

  6. Union for International Cancer Control. What is TNM? 2019. https://www.uicc.org. Accessed 17 Feb 2020.

  7. Nagtegaal ID, Quirke P, Schmoll H-J. Has the new TNM classification for colorectal cancer improved care? Nat Rev Clin Oncol. 2012;9:119–23.

    Article  Google Scholar 

  8. Mlecnik B, Bindea G, Angell HK, et al. Integrative analyses of colorectal cancer show Immunoscore is a stronger predictor of patient survival than microsatellite instability. Immunity. 2016;44(3):698–711.

    Article  CAS  Google Scholar 

  9. Sidaway P. Immunoscore provides a more accurate prognosis. Nat Rev Clin Oncol. 2018;15(8):471.

    Article  Google Scholar 

  10. Galon J, Costes A, Sanchez-Cabo F, et al. Type, density, and location of immune cells within human colorectal tumors predict clinical outcome. Science. 2006;313(5795):1960–4.

    Article  CAS  Google Scholar 

  11. Mlecnik B, Tosolini M, Kirilovsky A, et al. Histopathologic-based prognostic factors of colorectal cancers are associated with the state of the local immune reaction. J Clin Oncol. 2011;29(6):610–8.

    Article  Google Scholar 

  12. Pages F, Mlecnik B, Marliot F, et al. International validation of the consensus Immunoscore for the classification of colon cancer: a prognostic and accuracy study. Lancet. 2018;391(10135):2128–39.

    Article  Google Scholar 

  13. Hermitte F. Biomarkers immune monitoring technology primer: Immunoscore® Colon. J Immunother Cancer. 2016;4:57.

    Article  Google Scholar 

  14. HalioDx. Immunoscore®: scoring immune response in colon cancer for unmatched clinical performance in routine settings. 2019. https://www.immunoscore-colon.com/. Accessed 17 Feb 2020.

  15. Angell HK, Bruni D, Barrett JC, et al. The Immunoscore: colon cancer and beyond. Clin Cancer Res. 2019. https://doi.org/10.1158/1078-0432.Ccr-18-1851.

    Article  PubMed  Google Scholar 

  16. HalioDx. Immunoscore® Colon—CLIA HalioDx samples preparation instructions. 2019. https://www.immunoscore-colon.com. Accessed 17 Feb 2020.

  17. Galon J, Hermitte F, Mlecnik B, et al. Significant differences in outcome between Immunoscore categories in stage I colon cancer patients [abstract no. O-023 plus poster]. Ann Oncol. 2019;30(Suppl 4):iv134.

  18. Galon J, Hermitte F, Mlecnik B, et al. Immunoscore clinical utility to identify good prognostic colon cancer stage II patients with high-risk clinico-pathological features for whom adjuvant treatment may be avoided [abstract no. 487 plus poster]. J Clin Oncol. 2019;37(4 Suppl).

  19. Sinicrope FA, Shi Q, Hermitte F, et al. Immunoscore to provide prognostic information in low- (T1-3N1) and high-risk (T4 or N2) subsets of stage III colon carcinoma patients treated with adjuvant FOLFOX in a phase III trial (NCCTG N0147; Alliance) [abstract no. 614 plus poster]. J Clin Oncol. 2018;36(4 Suppl).

  20. Pages F, Andre T, Taieb J, et al. Validation of the Immunoscore prognostic value in stage III colon cancer patients treated with oxaliplatin in the prospective IDEA France cohort study (PRODIGE-GERCOR) [abstract no. 3513 plus poster]. J Clin Oncol. 2019;37(15 Suppl).

  21. Trabelsi M, Farah F, Zouari B, et al. An Immunoscore system based on CD3+ and CD8+ infiltrating lymphocytes densities to predict the outcome of patients with colorectal adenocarcinoma. Onco Targets Ther. 2019;12:8663–73.

    Article  CAS  Google Scholar 

  22. Anitei MG, Zeitoun G, Mlecnik B, et al. Prognostic and predictive values of the immunoscore in patients with rectal cancer. Clin Cancer Res. 2014;20(7):1891–9.

    Article  Google Scholar 

  23. Van den Eynde M, Mlecnik B, Bindea G, et al. The link between the multiverse of immune microenvironments in metastases and the survival of colorectal cancer patients. Cancer Cell. 2018;34(6):1012–1026.e3.

    Article  Google Scholar 

Download references

Acknowledgements

During the review process, the manufacturer of Immunoscore® was also offered an opportunity to review this article. Changes resulting from comments received were made on the basis of scientific and editorial merit.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Hannah A. Blair.

Ethics declarations

Funding

The preparation of this review was not supported by any external funding.

Conflict of interest

Hannah Blair is a salaried employee of Adis International Ltd/Springer Nature, is responsible for the article content and declares no relevant conflicts of interest.

Additional information

Enhanced material for this Adis Diagnostic Profile can be found at https://doi.org/10.6084/m9.figshare.11959206.

The manuscript was reviewed by:D. Páez, Medical Oncology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; M. Trabelsi, Department of Human Genetics, Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia; P. Waring, Department of Pathology, University of Melbourne, Melbourne, VIC, Australia.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Blair, H.A. Immunoscore®: A Diagnostic Assay for Clinical Management of Colon Cancer. Mol Diagn Ther 24, 365–370 (2020). https://doi.org/10.1007/s40291-020-00459-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40291-020-00459-6

Navigation