التفاصيل البيبلوغرافية
| العنوان: |
Comprehensive Intrametastatic Immune Quantification and Major Impact of Immunoscore on Survival. |
| المؤلفون: |
Mlecnik, Bernhard1,2,3,4, Van den Eynde, Marc1,2,3,5, Bindea, Gabriela1,2,3, Church, Sarah E.1,2,3, Vasaturo, Angela1,2,3, Fredriksen, Tessa1,2,3, Lafontaine, Lucie1,2,3, Haicheur, Nacilla6, Marliot, Florence1,2,3,6, Debetancourt, Daphné4, Pairet, Géraldine4, Jouret-Mourin, Anne4, Gigot, Jean-Francois4, Hubert, Catherine4, Danse, Etienne4, Dragean, Cristina4, Carrasco, Javier7, Humblet, Yves4, Valge-Archer, Viia8, Berger, Anne1,2,3,9 |
| المصدر: |
JNCI: Journal of the National Cancer Institute. 1/7/2018, Vol. 110 Issue 1, p1-108. 12p. |
| مصطلحات موضوعية: |
*ANTIGEN analysis, *ANTINEOPLASTIC agents, *PROTEIN analysis, *TREATMENT of lung tumors, *B cells, *ONCOLOGIC surgery, *CELL physiology, *COLON tumors, *COMBINED modality therapy, *HEPATECTOMY, *LIVER tumors, *LONGITUDINAL method, *LUNG tumors, *LYMPHOCYTES, *METASTASIS, *PNEUMONECTOMY, *PROGNOSIS, *SURVIVAL, *T cells, *CANCER treatment, *TREATMENT effectiveness, *PREOPERATIVE period, *LYMPHOCYTE count, *TUMOR treatment, RECTUM tumors |
| مستخلص: |
Background: This study assesses how the metastatic immune landscape is impacting the response to treatment and the outcome of colorectal cancer (CRC) patients.Methods: Complete curative resection of metastases (n = 441) was performed for two patient cohorts (n = 153). Immune densities were quantified in the center and invasive margin of all metastases. Immunoscore and T and B cell (TB) score were analyzed in relation to radiological and pathological responses and patient's disease-free (DFS) and overall survival (OS) using multivariable Cox proportional hazards models. All statistical tests were two-sided.Results: The spatial distribution of immune cells within metastases was nonuniform. Patients, as well as metastases of the same patient, had variable immune infiltrates and response to therapy. A beneficial response was statistically significantly associated with increased immune densities. Among all metastases, Immunoscore (I) and TB score evaluated in the least immune-infiltrated metastases were the strongest predictors for DFS and OS (five-year follow-up, Immunoscore: I 3-4: DFS rate = 27.9%, 95% CI = 15.2 to 51.3; vs I 0-1-2: DFS rate = 12.3%, 95% CI = 4.9 to 30.6; HR = 0.45, 95% CI = 0.28 to 0.70, P = .02; I 3-4: OS rate = 64.6%, 95% CI = 46.6 to 89.6; vs I 0-1-2: OS rate = 32.5%, 95% CI = 17.2 to 61.4; HR = 0.32, 95% CI = 0.15 to 0.66, P = .001, C-index = 65.9%; five-year follow-up, TB score: TB 3-4: DFS rate = 25.7%, 95% CI = 14.2 to 46.6; vs TB 0-1-2: DFS rate = 5.0%, 95% CI = 0.8 to 32.4; HR = 0.36, 95% CI = 0.22 to 0.57, P < .001; TB 3-4: OS rate = 63.7%, 95% CI = 46.4 to 87.5; vs TB 0-1-2: OS rate: 21.4%, 95% CI = 9.2 to 49.8; HR = 0.25, 95% CI = 0.12 to 0.51, P < .001, C-index = 67.8%). High TB score and Immunoscore patients had a median survival of 70.5 months, while low patients survived only 25.1 to 38.3 months. Nonresponding patients with high-immune infiltrates had prolonged DFS (HR = 0.28, 95% CI = 0.15 to 0.52, P = .001) and OS (HR = 0.25, 95% CI = 0.1 to 0.62, P = .001). The immune parameters remained the only statistically significant prognostic factor associated with DFS and OS in multivariable analysis (P < .001), while response to treatment was not.Conclusions: Response to treatment and prolonged survival of metastatic CRC patients were statistically significantly associated with high-immune densities quantified into the least immune-infiltrated metastasis. [ABSTRACT FROM AUTHOR] |
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