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Open Access Highly Accessed Editorial

The immune score as a new possible approach for the classification of cancer

Jérôme Galon12345*, Franck Pagès1234, Francesco M Marincola56, Magdalena Thurin7, Giorgio Trinchieri8, Bernard A Fox1059, Thomas F Gajewski115 and Paolo A Ascierto1213

Author Affiliations

1 INSERM, U872, Laboratory of Integrative Cancer Immunology, 15 Rue de l'Ecole de Medecine F-75006 Paris, France

2 Université Paris Descartes, Paris, 45 Rue Saints Pères 75006 Paris, France

3 Centre de Recherche des Cordeliers, Université Pierre et Marie Curie Paris 6, 15 rue de l'Ecole de medecine F-75006 Paris, France

4 Assistance Publique-Hopitaux de Paris, HEGP, 20-40 rue Leblanc, 75015 Paris, France

5 Society for ImmunoTherapy of Cancer, Milwaukee, 555 East Wells Street, Suite 1100 | Milwaukee, WI 53202-3823 USA

6 Infectious Disease and Immunogenetics Section (IDIS), Clinical Center and trans-NIH Center for Human Immunology (CHI), National Institutes of Health, Bethesda, Maryland, USA 20892

7 Cancer Diagnosis Program, National Cancer Institute (NCI), National Institutes of Health (NIH), Rockville, Maryland, 20852, USA

8 Cancer and Inflammation Program, Laboratory of Experimental Immunology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bldg. 560/Room 31-93, Frederick, Maryland 21702, USA

9 Laboratory of Molecular and Tumor Immunology, Earle A. Chiles Research Institute, Robert W. Franz Cancer Center, Providence Portland Medical Center, Portland, OR 97213, USA

10 Department of Molecular Microbiology and Immunology, Oregon Health and Science University, 3181 SW Sam Jackson Park Road L220 Portland, OR 97239, USA

11 Department of Pathology and Department of Medicine, Section of Hematology/Oncology, the University of Chicago, Chicago, IL 97239, USA

12 Medical Oncology and Innovative Therapies Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori, Fondazione "G. Pascale", Via Cappella dei Cangiani 1, 80131Napoli, Italy

13 Fondazione Melanoma Onlus Via Mariano Semmola, 80131 Napoli, Italy

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Journal of Translational Medicine 2012, 10:1  doi:10.1186/1479-5876-10-1

Published: 3 January 2012

Abstract

The outcome prediction in cancer is usually achieved by evaluating tissue samples obtained during surgical removal of the primary tumor focusing on their histopathological characteristics. Tumor staging (AJCC/UICC-TNM classification) summarizes data on tumor burden (T), presence of cancer cells in draining and regional lymph nodes (N), and evidence for metastases (M). However, this classification provides limited prognostic information in estimating the outcome in cancer and does not predict response to therapy. It is recognized that cancer outcomes can vary significantly among patients within the same stage. Recently, many reports suggest that cancer development is controlled by the host's immune system underlying the importance of including immunological biomarkers for the prediction of prognosis and response to therapy. Data collected from large cohorts of human cancers demonstrated that the immune-classification has a prognostic value that may be superior to the AJCC/UICC TNM-classification. Thus, it is imperative to begin incorporating immune scoring as a prognostic factor and to introduce this parameter as a marker to classify cancers, as part of the routine diagnostic and prognostic assessment of tumors. At the same time, the inherent complexity of quantitative immunohistochemistry, in conjunction with variable assay protocols across laboratories, the different immune cell types analyzed, different region selection criteria, and variable ways to quantify immune infiltration underscore the urgent need to reach assay harmonization. In an effort to promote the immunoscore in routine clinical settings worldwide, the Society for Immunotherapy of Cancer (SITC), the European Academy of Tumor Immunology, the Cancer and Inflammation Program, the National Cancer Institute, National Institutes of Health, USA and "La Fondazione Melanoma" will jointly initiate a task force on Immunoscoring as a New Possible Approach for the Classification of Cancer that will take place in Naples, Italy, February 13th, 2012. The expected outcome will include a concept manuscript that will be distributed to all interested participants for their contribution before publication outlining the goal and strategy to achieve this effort; a preliminary summary to be presented during the "Workshop on Tumor Microenvironment" prior to the SITC annual meeting on October 24th - 25th 2012 in Bethesda, Maryland, USA and finally a "Workshop on Immune Scoring" to be held in Naples in December of 2012 leading to the preparation of a summary document providing recommendations for the harmonization and implementation of the Immune Score as a new component for the classification of cancer.