Exploring immune status in peripheral blood and tumor tissue in association with survival in patients with multi-organ metastatic colorectal cancer

Oncoimmunology. 2024 Jun 10;13(1):2361971. doi: 10.1080/2162402X.2024.2361971. eCollection 2024.

Abstract

Colorectal cancer (CRC) raises considerable clinical challenges, including a high mortality rate once the tumor spreads to distant sites. At this advanced stage, more accurate prediction of prognosis and treatment outcome is urgently needed. The role of cancer immunity in metastatic CRC (mCRC) is poorly understood. Here, we explore cellular immune cell status in patients with multi-organ mCRC. We analyzed T cell infiltration in primary tumor sections, surveyed the lymphocytic landscape of liver metastases, and assessed circulating mononuclear immune cells. Besides asking whether immune cells are associated with survival at this stage of the disease, we investigated correlations between the different tissue types; as this could indicate a dominant immune phenotype. Taken together, our analyses corroborate previous observations that higher levels of CD8+ T lymphocytes link to better survival outcomes. Our findings therefore extend evidence from earlier stages of CRC to indicate an important role for cancer immunity in disease control even after metastatic spreading to multiple organs. This finding may help to improve predicting outcome of patients with mCRC and suggests a future role for immunotherapeutic strategies.

Keywords: Clinical-stage research; colorectal cancer; metastasis; prognostic biomarkers; systemic immunity; tumour immune microenvironment; tumour immunity.

MeSH terms

  • Adult
  • Aged
  • CD8-Positive T-Lymphocytes / immunology
  • Colorectal Neoplasms* / immunology
  • Colorectal Neoplasms* / mortality
  • Colorectal Neoplasms* / pathology
  • Female
  • Humans
  • Liver Neoplasms* / immunology
  • Liver Neoplasms* / mortality
  • Liver Neoplasms* / secondary
  • Lymphocytes, Tumor-Infiltrating / immunology
  • Male
  • Middle Aged
  • Neoplasm Metastasis
  • Prognosis

Grants and funding

The ORCHESTRA trial is financially supported by KWF (Dutch Cancer Foundation), Blokker-Verwer Foundation and Roche. DVFT received funding from the Radboudumc (Hypatia Fellowship) and NWO/ZonMW (Dutch Research Council, VIDI 91719371).