Evaluating the body’s immune response to cancerous tumors is crucial for determining risk of relapse and need for chemotherapy, but traditional methods of determining risk are inconsistent and outdated.
The Immunoscore® test — offered by immuno-oncology diagnostic company HalioDx — is changing this paradigm for people with localized colon cancer by delivering accurate, timely results that can predict patients’ risk of relapse and help guide decision-making about treatment options.
“For the first time, with Immunoscore®, we have a way to actually measure something that is so specific,” said Graham Poage, Ph.D., HalioDx’s medical science liaison director, “and that’s the ability of the immune system to be present and potentially active within a cancer to restrain it.”
There’s a large patient population that can directly benefit from the information that Immunoscore® provides. In the United States alone, there were an estimated 100,000 newly diagnosed cases of colon cancer in 2020. For those living with the disease, quality of life is greatly impacted, both from the cancer itself and the therapies used to treat it.
Even in its early stages, colon cancer is associated with pain, constipation, diarrhea, and blood in the stool. But the side effects of chemotherapy can be even worse, especially if there’s no, or low, risk of the cancer metastasizing.
“There are issues associated with cancer treatment, including things like chemotherapy, which can cause fatigue, nausea, and vulnerability to infection,” said Dr. Benjamin Weinberg, M.D., associate professor of medicine at MedStar Georgetown University. “Also, some of our chemotherapies cause neuropathy, so this means damage to nerves, numbness, tingling, and decreased sensation. Radiation also impacts quality of life in terms of bowel movements, in terms of sexual dysfunction, and in terms of fertility.”
Cancer is graded on a scale of 0-IV based on the extent to which the tumor has spread within the affected organ, and whether it has spread to the lymph nodes or a different part of the body (metastasized). However, this scale ignores the body’s immune response to the tumor, which is a far better indicator of relapse risk.
“Historically, we’ve been basing these decisions off of what is essentially 19th-century technology,” Dr. Weinberg said. “One could easily argue that doesn’t adequately reflect the biology of what’s going on in the tumor.”
The immune system plays a major role in fighting back against cancers — as it can be used to develop immunotherapies — and it’s increasingly being used to evaluate the evolution of cancers.
Prescribed after resection surgery, the Immunoscore® test determines the body’s immune response to the cancer by counting two types of immune cells (CD3+ and CD8+ T lymphocytes) in two specific regions of the tumor. If the presence of these cells is high, it will register as “Immunoscore® High” (meaning there’s a low risk for metastasis), while a low presence of cells is indicated by “Immunoscore® Low” and a higher risk of relapse.
“What we really have is a novel way to look at tumor biology, where a patient’s immune reaction to a tumor can be directly measured and it’s activity state predicts whether the tumor is likely to return,” Poage said.
“Immunoscore® gives us more information about the patient’s tumor, and allows us to make more individualized, more informed decisions,” Dr. Weinberg said.
Immunoscore® has been validated in an international study of more than 2,500 patients with stages I-III colon cancer (Pagès et al, The Lancet, 2018). In the study, Immunoscore® was demonstrated to be a powerful and independent prognostic factor for patient survival, providing the greatest contribution to patient prognostication of all assessed factors.
Immunoscore® was included in the 2020 European Society of Medical Oncology Clinical Practice Guidelines for diagnosis, treatment, and follow-up for localized colon cancer and immune response is now considered by the World Health Organization to be an essential and desirable diagnostic criterion for colorectal cancer.
See how Immunoscore® can help you take charge of your colon cancer care by visiting www.immunoscore-colon.com/for-healthcare-professionals/, and ask your doctor if Immunoscore® is right for you.