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    The Glasgow Microenvironment Score associates with prognosis and adjuvant chemotherapy response in colorectal cancer

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    Authors
    Alexander, P. G.
    Roseweir, A. K.
    Pennel, K. A. F.
    van Wyk, H. C.
    Powell, A.
    McMillan, D. C.
    Horgan, P. G.
    Kelly, C.
    Hay, J.
    Sansom, O.
    Harkin, A.
    Roxburgh, C. S. D.
    Graham, J.
    Church, D. N.
    Tomlinson, I.
    Saunders, Mark P
    Iveson, T. J.
    Edwards, J.
    Park, J. H.
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    Affiliation
    School of Medicine, University of Glasgow, Glasgow, UK
    Issue Date
    2020
    
    Metadata
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    Abstract
    Background: The Glasgow Microenvironment Score (GMS) combines peritumoural inflammation and tumour stroma percentage to assess interactions between tumour and microenvironment. This was previously demonstrated to associate with colorectal cancer (CRC) prognosis, and now requires validation and assessment of interactions with adjuvant therapy. Methods: Two cohorts were utilised; 862 TNM I-III CRC validation cohort, and 2912 TNM II-III CRC adjuvant chemotherapy cohort (TransSCOT). Primary endpoints were disease-free survival (DFS) and relapse-free survival (RFS). Exploratory endpoint was adjuvant chemotherapy interaction. Results: GMS independently associated with DFS (p = 0.001) and RFS (p < 0.001). GMS significantly stratified RFS for both low risk (GMS 0 v GMS 2: HR 3.24 95% CI 1.85-5.68, p < 0.001) and high-risk disease (GMS 0 v GMS 2: HR 2.18 95% CI 1.39-3.41, p = 0.001). In TransSCOT, chemotherapy type (pinteraction = 0.013), but not duration (p = 0.64) was dependent on GMS. Furthermore, GMS 0 significantly associated with improved DFS in patients receiving FOLFOX compared with CAPOX (HR 2.23 95% CI 1.19-4.16, p = 0.012). Conclusions: This study validates the GMS as a prognostic tool for patients with stage I-III colorectal cancer, independent of TNM, with the ability to stratify both low- and high-risk disease. Furthermore, GMS 0 could be employed to identify a subset of patients that benefit from FOLFOX over CAPOX
    Citation
    Alexander PG, Roseweir AK, Pennel KAF, van Wyk HC, Powell A, McMillan DC, et al. The Glasgow Microenvironment Score associates with prognosis and adjuvant chemotherapy response in colorectal cancer. Br J Cancer. 2020.
    Journal
    British Journal of Cancer
    URI
    http://hdl.handle.net/10541/623624
    DOI
    10.1038/s41416-020-01168-x
    PubMed ID
    33223535
    Additional Links
    https://dx.doi.org/10.1038/s41416-020-01168-x
    Type
    Article
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.1038/s41416-020-01168-x
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