Research Perspectives:

The “Immunoscore” in rectal cancer: could we search quality beyond quantity of life?

Amos Kirilovsky, Carine El Sissy, Guy Zeitoun, Florence Marliot, Nacilla Haicheur, Christine Lagorce-Pagès, Julien Taieb, Mehdi Karoui, Petra Custers, Edina Dizdarevic, Soledad Iseas, Torben Frøstrup Hansen, Lars Henrik Jensen, Geerard Beets, Jean Pierre Gérard, Mireia Castillo-Martin, Nuno Figueiredo, Angelita Habr-Gama, Rodrigo Perez, Jérôme Galon and Franck Pagès _

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Oncotarget. 2022; 13:18-31. https://doi.org/10.18632/oncotarget.28100

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Amos Kirilovsky1,2,3,4,*, Carine El Sissy1,2,3,4,*, Guy Zeitoun4,*, Florence Marliot1,2,3,4, Nacilla Haicheur4, Christine Lagorce-Pagès1,2,3,5, Julien Taieb6, Mehdi Karoui7, Petra Custers8,9, Edina Dizdarevic10,11, Soledad Iseas12, Torben Frøstrup Hansen10,11, Lars Henrik Jensen10,11, Geerard Beets8,9, Jean Pierre Gérard13, Mireia Castillo-Martin14, Nuno Figueiredo15,16, Angelita Habr-Gama17, Rodrigo Perez17, Jérôme Galon1,2,3 and Franck Pagès1,2,3,4

1 Laboratory of Integrative Cancer Immunology, INSERM, Paris, France

2 Equipe Labellisée Ligue Contre le Cancer, Paris, France

3 Centre de Recherche des Cordeliers, Sorbonne Université, Université de Paris, Paris, France

4 Immunomonitoring Platform, Laboratory of Immunology, Assistance Publique-Hôpitaux de Paris (AP-HP), Georges Pompidou European Hospital, Paris, France

5 Department of Pathology, AP-HP, Georges Pompidou European Hospital, Paris, France

6 Department of Gastroenterology and Gastrointestinal Oncology, AP-HP, Georges Pompidou European Hospital, Université de Paris, Paris, France

7 Department of Digestive Surgery, AP-HP, Georges Pompidou European Hospital, Université de Paris, Paris, France

8 Department of Surgery, Netherlands Cancer Institute – Antoni van Leeuwenhoek, Amsterdam, The Netherlands

9 GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands

10 Department of Oncology, Vejle Hospital, University Hospital of Southern Denmark, Vejle, Denmark

11 Danish Colorectal Cancer Center South, Vejle Hospital, Vejle, Denmark

12 Oncology Unit, Gastroenterology Hospital, Dr. Carlos Bonorino Udaondo, Ciudad Autónoma de Buenos Aires, Argentina

13 Department of Radiation Oncology, Centre Antoine Lacassagne, Nice Sophia-Antipolis University, Nice, France

14 Service of Pathology, Champalimaud Foundation Biobank (CFB)/Champalimaud Centre for the Unknown/Champalimaud Foundation, Lisbon, Portugal

15 Colorectal Surgery, Digestive Department, Champalimaud Foundation, Lisbon, Portugal

16 Colorectal Surgery, Lusiadas Hospital Lisboa, Lisbon, Portugal

17 Department of Colorectal Surgery, Angelita & Joaquim Gama Institute, São Paulo, Brazil

* These authors contributed equally to this work

Correspondence to:

Franck Pagès, email: [email protected]

Keywords: rectal cancer; immunoscore; watch and wait; prognosis; radiochemotherapy

Received: September 15, 2021     Accepted: September 26, 2021     Published: January 05, 2022

Copyright: © 2022 Kirilovsky et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Because of the function and anatomical environment of the rectum, therapeutic strategies for local advanced rectal cancer (LARC) must deal with two challenging stressors that are a high-risk of local and distal recurrences and a high-risk of poor quality of life (QoL). Over the last three decades, advances in screening tests, therapies, and combined-modality treatment options and strategies have improved the prognosis of patients with LARC. However, owing to the heterogeneous nature of LARC and genetic status, the patient may not respond to a specific therapy and may be at increased risk of side-effects without the life-prolonging benefit. Indeed, each therapy can cause its own side-effects, which may worsen by a combination of treatments resulting in long-term poor QoL. In LARC, QoL has become even more essential with the increasing incidence of rectal cancer in young individuals. Herein, we analyzed the value of the Immunoscore-Biopsy (performed on tumor biopsy at diagnosis) in predicting outcomes, alone or in association with clinical and imaging data, for each therapy used in LARC.

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