Nov 17, 2014

Immunoscore / Immunoprofile: Assessing Anti-Cancer Immunity as a Biomarker to Stratify Patients for Clinical Trials

Dr. Carlo Bifulco, Medical Director, Oncologic Molecular Pathology and Pathology Informatics, Director, Translational Molecular Pathology, Providence Oregon Regional Laboratory & Earle A. Chiles Research Institute, Providence Health & Services, Portland, Oregon, USA

There is a significant need for innovative prognostic and predictive biomarkers of recurrence, response to therapy, and survival for patients with cancer. Increasing evidence suggests that the number, type and location of tumor-infiltrating lymphocytes in primary tumors has prognostic value, and this has led to the development of an “immunoscore”. Image analysis technology, such as Definiens, is particularly well suited to objectively and qualitatively characterize the tumor microenvironment and is being used by the Society for Immunotherapy of Cancer (SITC) led global immunoscore initiative that seeks to validate the immunoscore as a prognostic biomarker for patients with colon cancer. The immunoscore concept also has the potential to help predict response to treatment, thereby improving decision making with regard to choice of therapy. However, unlike molecular targeted therapies, where biomarkers are often provided by the tumor's driver mutation profile, strong predictive biomarkers for novel immunotherapies have not yet been clinically validated. This predictive aspect of the tumor microenvironment forms the basis for the concept of immunoprofiling, which can be described as using an individual’ s immune system signature (or profile) to predict that patient’ s response to standard therapies as well as novel immunotherapies and to stratify patients enrolled on clinical trials. The characterization of the tumor immune microenvironment and of the tumor-host interaction via immunoprofiling may enable the individual tailoring of immunotherapies such as immune checkpoint blockade. Furthermore, immunoprofiling may also enable and guide the manipulation of the tumor microenvironment, via for example epigenetic modulating drugs, in order to overcome mechanisms of resistance.