Prognostic and predictive value of the Immunoscore in stage III colon cancer patients treated with mFOLFOX6 (three versus six months) in the prospective IDEA France cohort study (PRODIGE-GERCOR).

Authors

null

Franck Pages

Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Sorbonne Paris Cité, Université Paris Descartes, Université Paris Diderot, Université de Paris, Paris, France

Franck Pages , Thierry Andre , Julien Taieb , Dewi Vernerey , Julie Henriques , Christophe Borg , Florence Marliot , Rim Ben Jannet , Christophe Louvet , Laurent Mineur , Jaafar Bennouna , Jérôme Desrame , Roger Faroux , Alex Duval , Pierre Laurent-Puig , Magali Svrcek , Fabienne Hermitte , Aurelie Catteau , Jerome Galon , Jean-François Emile

Organizations

Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Sorbonne Paris Cité, Université Paris Descartes, Université Paris Diderot, Université de Paris, Paris, France, Hôpital Saint Antoine, Assistance Publique Hôpitaux de Paris, Sorbonne Université, Paris, France, Hôpital Européen Georges-Pompidou, Sorbonne Paris Cite/Paris Descartes University, Paris, France, Methodology and Quality of Life in Oncology Unit, Besançon University Hospital, Besançon, France, University Hospital of Besançon, Besançon, France, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Sorbonne Paris Cité, Université Paris Descartes/Université Paris Diderot/Université de Paris, Paris, France, Ambroise Paré Hospital, AP-HP; EA4340-BECCOH, Versailles University, Boulogne, France, Institut Mutualiste Montsouris, Paris, France, Institut Sainte-Catherine, Avignon, France, University Hospital of Nantes, Digestive Oncology, Nantes, France, Hopital Prive Jean Mermoz, Lyon, France, CHD Vendée, La Roche-Sur-Yon, France, Sorbonne Universités, UPMC Univ Paris 06, INSERM, Centre de Recherche Saint-Antoine (CRSA), Paris, France, Paris Descartes University, Université Sorbonne Paris Cité, INSERM UMR-S1147 MEPPOT, CNRS SNC5014, Centre Universitaire des Saints-Pères, Equipe Labellisée Ligue Nationale Contre le Cancer, Paris, France, Sorbonne University, Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Paris, France, HalioDx, Marseille, France, Sorbonne Paris Cité, Université Paris Descartes/Université Paris Diderot/Université de Paris, Laboratory of Integrative Cancer Immunology, INSERM UMRS1138, Cordeliers Research Center, Paris, France, Ambroise Paré Hospital, Versailles University, EA4340-BECCOH, Versailles University, Boulogne, France

Research Funding

Other
GERCOR

Background: In stage III colon cancer patients treated with CAPOX, 3 months of therapy was as effective as 6 months. It was not the case for those receiving mFOLFOX6. We assessed the prognostic and predictive value of the Immunoscore (IS) in the mFOLFOX6 subgroup (90% of patients enrolled) of the IDEA France cohort study. Methods: 1200 patients randomly assigned to 3 months (n = 593) or 6 months (n = 607) of mFOLFOX6, with available tumor sample, were included. Densities of CD3+ and cytotoxic CD8+ T-cells in the tumor and invasive margin were determined by immunohistochemistry, quantified by digital pathology, and converted to IS using the pre-defined cut-off. The IS performance to predict disease-free survival (DFS) was assessed in each arm and adjusted in multivariate Cox models. Results: In a two-category IS analysis, Low and (Int+High) IS were observed in 423 (43.5%) and 550 (56.5%) patients, respectively. Low IS identified patients with higher-risk of relapse or death (HR = 1.60; 95% CI 1.27-2.01, P < 0.0001). The 3-year DFS was 66.34% (95% CI 61.54-70.69) and 77.66% (95% CI 73.86-80.97) for Low and (Int+High) IS, respectively. In multivariate analysis, IS remained independently associated with DFS (P = 0.0007) when combined with T/N stage. A statistically significant interaction was observed for the IS predictive value for treatment duration (3 vs 6 months) in term of DFS in the whole population (P = 0.0566) and TN subgroups (Low-risk T1-3, N1 vs High-risk T4 and/or N2; P = 0.0015). The 3-year DFS of patients with (Int+High) IS in the 3-month arm was 71.5% (95% CI 65.7-76.6) versus 83.8% (95% CI, 78.8-87.8) in the 6-month arm (HR = 0.528; 95% CI 0.372-0.750; log-rank P = 0.0004); the benefit retained in low-risk and high-risk patients (all P≤0.010). 6-month mFOLFOX6 showed no significant benefit for patients with Low IS (HR = 0.836, log-rank P = 0.269). Conclusions: The IS prognostic value in patients treated with mFOLFOX6 was confirmed. Its predictive value for benefit of longer duration treatment, despite a strong statistical signal, needs to be confirmed in an external validation cohort. Clinical trial information: NCT03422601

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Abstract Details

Meeting

2020 Gastrointestinal Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session C: Anal and Colorectal Cancer

Track

Colorectal Cancer,Anal Cancer

Sub Track

Diagnostics

Clinical Trial Registration Number

NCT03422601

Citation

J Clin Oncol 38, 2020 (suppl 4; abstr 10)

Abstract #

10

Poster Bd #

A1

Abstract Disclosures