The “Immunoscore” in rectal cancer: could we search quality beyond quantity of life?
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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
Keywords: rectal cancer; immunoscore; watch and wait; prognosis; radiochemotherapy
Received: September 15, 2021 Accepted: September 26, 2021 Published: January 05, 2022
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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