Top line:
Immunoscore biopsy quantifies immune cell tumor infiltration in tumor biopsies at baseline; rectal cancer For both local regrowth and distant metastases, careful follow-up is required to prevent recurrence.
methodology:
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Currently, oncologists do not have biomarkers to help select rectal cancer patients for watchful waiting after neoadjuvant chemoradiotherapy or to monitor patients long-term. And approximately 25% of patients on follow-up will eventually relapse.
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Immunoscore biopsies examine the density of CD3- and CD8-positive T cells at baseline to determine immune infiltration in pre-treatment tumor biopsies, given that larger infiltrates are associated with prolonged treatment response. Quantify the degree of
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To determine whether Immunoscore can help select patients for watchful waiting, researchers investigated whether stage I-III rectum undergoing watchful waiting after a complete clinical response to neoadjuvant chemoradiation therapy We correlated immunoscore and time to recurrence in 249 patients.
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CD3- and CD8-positive T-cell densities were converted to percentiles and translated into immunoscore biopsy scores: low (0%–25%), moderate (>25%–70%), and high (>70). % to 100) %).
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Immunoscore biopsy significantly improved prediction of recurrence. The 5-year recurrence-free survival rate was 91.3% for patients with high scores, 62.5% for patients with intermediate scores, and 53.1% for patients with low scores.
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Immune score was significantly associated with disease-free survival (log-rank) P = .0002), predicted both local regrowth and distant metastasis.
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Multivariate analysis showed that the predictive ability of Immunoscore was independent of age, sex, tumor location, cT stage, and cN stage, and it was the strongest predictor of time to recurrence (hazard ratio, Low, 6.93. P = .0017).
in fact:
This validation study confirms that Immunoscore biopsy is an “independent parameter predicting time to recurrence” and may help doctors and patients decide whether to opt for observation. The study authors wrote:
sauce:
The study, led by Karine El Sissy of the Institute for Integrative Cancer Immunology in Paris, was published in the journal Oct. 3. Journal of Clinical Oncology.
Limitations:
The expression status of mismatch repair genes was not assessed.
Disclosure:
This research was supported by the National Institutes of Health and others. Investigators uncovered patents related to the research and connections to a number of companies, including Amgen, AstraZeneca and Merck. One of his researchers is Novo, an employee of Nordisk, and one of his researchers is employed by Veracyte.
M. Alexander Otto is a physician assistant who earned a master’s degree in medicine and a degree in journalism from Newhouse. He is an award-winning medical journalist who worked for several major news organizations before joining Medscape. Alex is also an MIT Knight Fellow in Science Journalism. Email: aotto@mdedge.com
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