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

Alexander, P.G. et al. (2021) The Glasgow Microenvironment Score associates with prognosis and adjuvant chemotherapy response in colorectal cancer. British Journal of Cancer, 124, pp. 786-796. (doi: 10.1038/s41416-020-01168-x) (PMID:33223535)

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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.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Park, Mr James and Horgan, Professor Paul and Roseweir, Dr Antonia and Pennel, Miss Kathryn and Roxburgh, Professor Campbell and Hay, Dr Jennifer and Edwards, Professor Joanne and Kelly, Mrs Caroline and Graham, Dr Janet and Alexander, Peter and McMillan, Professor Donald and Sansom, Professor Owen and Harkin, Mrs Andrea and Van Wyk, Dr Hester
Authors: Alexander, P.G., Roseweir, A.K., Pennel, K.A.F., van Wyk, H.C., Powell, A.G.M.T., 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, M., Iveson, T.J., Edwards, J., and Park, J.H.
College/School:College of Medical Veterinary and Life Sciences > School of Cancer Sciences
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:British Journal of Cancer
Publisher:Nature Research
ISSN (Online):1532-1827
Published Online:23 November 2020
Copyright Holders:Copyright © 2020 The Authors
First Published:First published in British Journal of Cancer 124:786-796
Publisher Policy:Reproduced in accordance with the publisher copyright policy

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
174115CRUK Centre RenewalOwen SansomCancer Research UK (CRUK)C7932/A25142CS - Beatson Institute for Cancer Research