SCIENCE From Tumor Cells Profiling

to Tumor Immune Scoring

Although cancer is a "gene disease," we now know that the tumor establishes an ongoing dialogue with its complex microenvironment. This medium, in particular the immune cells in contact with the tumor, affects tumor progression and the clinical outcome of patients.

With its immune scoring system, HalioDx paves the way for a new concept in personalized medicine, introducing a new parameter that determines the patient's clinical evolution. This new approach is the result of three scientific and technological advances :

The immune Contexture

By exploring the immune micro-environment of tumors, immunologists have revealed the key role of anti-tumoral immunity, a previously neglected mechanisms.  Described as the “immune contexture” of tumors (Galon J et al.  Science 2006), the type, density, location and immune functions of adaptive immune cells within distinct tumor regions is strongly related with tumor progression and clinical outcome in patients.  

These discoveries have opened two complementary fields of application: immune modulation as therapeutic strategy and immunoscore as a diagnostic approach to assess the status of the patient tumor immunity.  

Immunoscore®

The Immunoscore® is derived from three aspects of the Immune Contexture: the type, density, and location of the immune cells. A number of studies (Pages F et al. JCO 2009, Mlecnik B et al., JCO 2011) demonstrate the superiority of Immunoscore®, notably in colorectal cancer, compared to the standard AJCC-IUCC-TNM staging algorithm. Pathological evaluation of the Immune Contexture using the Immunoscore® as part of the routine assessment of tumors as the potential to provide new prognostic and decision tool for treatment of cancers.  

The functional orientation of the Immune Contexture (the immune functions of each targeted T lymphocytes) can be explored by immune signatures related to broader phenomenon of immune-mediated tissue specific destruction. By unlocking T cells, the first generation of immunomodulatory antibodies (primarily anti-CTLA-4 and anti-PD-1 / PD-L1 antibodies) has made it possible to sustainably extend the life of cancer patients with very poor prognosis. However, not all patients respond to these treatments. Thanks to the immune tumor diagnosis, we should soon be able to predict who will robustly respond to these drugs.  

Integrative immunology

To understand the complexity of immunology and tumor biology, scientists now combine ”omics" technologies, predictive models and biological samples from patients with advanced computing technologies. This new synthetic approach has revealed the many facets of the immune response and the dynamics of the host-tumor relationship, including the impact of distinct immune cell populations present at the tumor site, on disease outcome.