TYPE: New Zealand Research Study
STATUS: In recruitment
GCF CONTRIBUTION: $100,000

Colorectal Cancer Immunoscoring

Traditionally, diagnosing a stage 2 and 3 colorectal cancer has not provided an accurate prognosis and an appropriate level of treatment. As such, researchers have sought to develop a tool that more accurately predicts prognosis for this group of patients.

Immunoscoring is a system designed to measure the extent to which a few parts of the patient’s immune system has affected (infiltrated) colorectal cancer tumours. It identifies two cell markers which could play a role as more accurate predictors of a patient’s susceptibility to tumour recurrence and therefore a more accurate predictor of their potential outcome.

Early evidence suggested confirms that immunoscoring stage II and III colorectal cancer patients could be used to provide more accurate prognosis and therefore give patients more tailored treatments and hopefully improve survival rates.

Further research in NZ has taken these findings and confirmed in a very small cohort that immunoscoring was able to predict whether or not tumours would recur in patients with stage II colorectal cancer – confirming that proactive use of immunoscoring has the potential for far more accurate prognosis and tailored treatment plans.

But, this research was only conducted on a small number of tumour samples. Significant research was required to establish whether immunoscoring is an effective prognosis tool using a much larger selection of tumour samples. This work needs to be established before immunoscoring can be used as standard practice.

However, the existing techniques for immunoscoring were extremely expensive, and therefore inaccessible to researchers and clinicians in NZ. Other tentative methods were very labour intensive and not easily translated into practical diagnostic settings. As such, new more efficient immunoscoring techniques needed to be developed to make this additional research possible and help it translate into a clinical setting if the research provides positive outcomes.

To address these issues, Dr Rhodes designed her PhD to:

• establish the techniques necessary to enable immunoscoring of a much larger set of patients and ensure the technique is translatable into a diagnostic setting

• establish whether this refined immunoscore technique does in fact add value to determining the prognosis of NZ colorectal cancer patients

• Identify additional characteristics of the immune response (cell markers) to the tumour that could add to the efficacy of immunoscore as a diagnostic tool

Results

To date, Dr Rhodes' research has successfully managed to:

• develop a new, quicker, more efficient, cheaper immunoscoring technique that allows her to test and validate the technique against tumour specimens from over 500 NZ colorectal cancer patients

• identify additional immune responses and cell markers that could help improve the accuracy of the technique

• develop a system that, with some refinement, may have an immediate impact on the treatment of New Zealanders with stage II and III colorectal cancer by providing a more accurate prognosis and allowing for a more personalised treatment plan

• developed a system that could have immediate benefits to Kiwis whilst simultaneously contributing to a much wider global effort to improve the accuracy of the Immunoscore as a prognostic tool

• GCF is grateful to the Hugh Green Foundation for their support of this research.