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Value of biomarkers in colorectal cancer depends on tumor location
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The prognostic impact of tumor-infiltrating lymphocytes for colorectal cancer differed based on primary tumor site, according to study results scheduled for presentation at the 2017 ASCO-SITC Clinical Immuno-Oncology Symposium.
Results showed high density of tumor-infiltrating lymphocytes (TILs) was most associated with improved outcomes among patients with right-sided tumors.
Prior studies demonstrated an association between high TIL density and longer survival for patients with colorectal cancer. However, it was unknown if these associations differ by tumor location.
Researchers evaluated the density of three types of TILs — cytotoxic T cells, regulatory T cells and natural killer T cells — by assessing the immunohistochemical expression of CD3, CD8, FocP3 and CD56 in tissue microarrays from 557 patients with colorectal cancer.
Results showed high density of all investigated immune cells were linked to improved 5-year OS in all patients. The association persisted in multivariable analyses adjustment for age, TNM stage, differentiation grade and vascular invasion.
However, the prognostic impact of specific types of TILs differed by tumor location.
Dense infiltration of CD3–positive (HR = 0.53; 95% CI, 0.29-0.95) and CD8–positive (HR = 0.35; 95% CI, 0.19-0.65) cells appeared to be favorable prognostic factors for tumors in the right colon, but not in the left colon or rectum. However, after adjusting for microsatellite instability status, CD8–positive cells remained the only prognostic factor for right-sided tumors.
Dense infiltration of FoxP3–positive cells appeared to be a prognostic factor for tumors in the rectum (HR = 0.54; 95% CI, 0.3-0.99), but not in the right or left colon.
Infiltration of CD56–positive cells carried no prognostic impact after stratifying for primary tumor site.
“This study suggests we may need to give more weight to certain prognostic biomarkers based on tumor location,” Jonna Berntsson, PhD student at Lund University in Sweden, said in a press release. “But more research is needed before we can recommend any change in treatment planning.”
Tumor location may be an important factor to consider in therapeutic decisions, particularly for immunotherapy eligibility, according to researchers.
“We’ve seen prior research showing that the location of a colorectal cancer tumor can help predict a patient’s survival, and this study adds another layer of information that can help further personalize treatment,” Lynn Schuchter, MD, FASCO, chief of the division of hematology and oncology at Perelman Center for Advanced Medicine, attending physician at Hospital of the University of Pennsylvania, and an ASCO expert who was not involved in the study, said in the release. – by Kristie L. Kahl
Reference:
Berntsson J, et al. Abstract 47. Presented at: ASCO-SITC Clinical Immuno-Oncology Symposium; Feb. 24-26; Orlando, Fla.
Disclosure: The researchers report no relevant financial disclosures.