Abstract

The international American Joint Committee on Cancer/Union for International Cancer Control (AJCC/UICC) tumour-node-metastasis (TNM) staging system provides the current guidelines for the classification of cancer. However, among patients within the same stage, the clinical outcome can be very different. More recently, a novel definition of cancer has emerged, implicating at all stages a complex and dynamic interaction between tumour cells and the immune system. This has enabled the definition of the immune contexture, representing the pre-existing immune parameters associated with patient survival. Even so, the role of distinct immune cell types in modulating cancer progression is increasingly emerging. An immune-based assay named the 'Immunoscore' was defined to quantify the in situ T cell infiltrate and was demonstrated to be superior to the AJCC/UICC TNM classification for patients with colorectal cancer. This Review provides a broad overview of the main immune parameters positively or negatively shaping cancer development, including the Immunoscore, and their prognostic and predictive value. The importance of the immune system in cancer control is demonstrated by the requirement for a pre-existing intratumour adaptive immune response for effective immunotherapies, such as checkpoint inhibitors. Finally, we discuss how the combination of multiple immune parameters, rather than individual ones, might increase prognostic and/or predictive power.

Keywords

Immune systemMedicineCancerOncologyIntensive care medicineInternal medicineImmunology

MeSH Terms

Antineoplastic AgentsImmunologicalBiomarkersTumorColorectal NeoplasmsDisease ProgressionHumansImmune Checkpoint InhibitorsImmune SystemImmunoassayNeoplasm StagingNeoplasmsPredictive Value of TestsPrognosisRisk AssessmentSeverity of Illness IndexSurvival AnalysisTreatment Outcome

Affiliated Institutions

Related Publications

Publication Info

Year
2020
Type
review
Volume
20
Issue
11
Pages
662-680
Citations
1533
Access
Closed

Social Impact

Social media, news, blog, policy document mentions

Citation Metrics

1533
OpenAlex
0
Influential

Cite This

Daniela Bruni, Helen K. Angell, Jérôme Galon (2020). The immune contexture and Immunoscore in cancer prognosis and therapeutic efficacy. Nature reviews. Cancer , 20 (11) , 662-680. https://doi.org/10.1038/s41568-020-0285-7

Identifiers

DOI
10.1038/s41568-020-0285-7
PMID
32753728

Data Quality

Data completeness: 81%