Immune cell score as a predictor of adjuvant chemotherapy effectiveness in stage II colorectal cancer
Background: Adjuvant chemotherapy (ACT) in stage II colorectal cancer (CRC) provides limited benefit overall, and current risk stratification based on pathologic features lacks precision. A more objective biomarker could better guide ACT decisions and minimize overtreatment. This study was undertake...
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| Auteurs principaux: | , , , , , |
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| Format: | Article (Journal) |
| Langue: | anglais |
| Publié: |
February 2026
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| In: |
Journal of the National Comprehensive Cancer Network
Year: 2026, Volume: 24, Numéro: 4, Pages: 1-7 |
| ISSN: | 1540-1413 |
| DOI: | 10.6004/jnccn.2025.7112 |
| Accès en ligne: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.6004/jnccn.2025.7112 Verlag, lizenzpflichtig, Volltext: https://jnccn.org/view/journals/jnccn/24/4/article-e257112.xml 
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| Notes sur l'auteur: | Durgesh Wankhede, MD, Dominic Edelmann, PhD, Niels Halama, MD, PhD, Matthias Kloor, MD, Hermann Brenner, MD, MPH, and Michael Hoffmeister, PhD |
| Résumé: | Background: Adjuvant chemotherapy (ACT) in stage II colorectal cancer (CRC) provides limited benefit overall, and current risk stratification based on pathologic features lacks precision. A more objective biomarker could better guide ACT decisions and minimize overtreatment. This study was undertaken to evaluate whether the immune cell score (ICS) is prognostic and predicts ACT effectiveness in stage II CRC. Patients and Methods: This study included 843 patients with surgically resected stage II CRC from the population-based Darmkrebs: Chancen der Verhütung durch Screening (DACHS) study who had available ICS and ACT data. ICS was determined using automated quantification of CD3+ and CD8+ T-cell densities in the tumor core and invasive margin and was categorized as high (ICShi) or low (ICSlo) based on validated thresholds. Associations with disease-free survival (DFS) were assessed using multivariable Cox regression models. Results: Patients with ICShi tumors had more favorable DFS (hazard ratio [HR], 0.48; 95% CI, 0.29-0.78), particularly among microsatellite-stable tumors, stage IIA disease, and pathologic high-risk subgroups. In patients with stage IIA disease, ACT was not significantly associated with DFS (HR, 0.82; 95% CI, 0.44-1.53). However, among those with stage IIB-C disease, ACT was associated with improved DFS (HR, 0.33; 95% CI, 0.12-0.91), particularly in ICSlo tumors (HR, 0.37; 95% CI, 0.13-0.87). Conclusions: ICS is a strong prognostic biomarker in stage II CRC and may help refine ACT decision-making, particularly in stage IIB-C disease. Integrating ICS into clinical workflows could enable personalized adjuvant therapy by directing ACT to patients most likely to benefit. |
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| Description: | Online veröffentlicht: 26. Februar 2026 Gesehen am 10.06.2026 |
| Description matérielle: | Online Resource |
| ISSN: | 1540-1413 |
| DOI: | 10.6004/jnccn.2025.7112 |