Immune monitoring in patients with colorectal cancer stage II

Immunoscore has been shown to be a very powerful prognositc indicator in patients with clinically localized colorectal cancer, with no detectable tumour spread to lymph nodes or distant organs. These patients are usually treated with surgical removal of the tumour only. However, approximately 25% of these patients will have recurrence of their disease. No tumour-associated marker to predict the recurrence of this subgroup of patients and define who could benefit from adjuvant therapy is used in clinical routine[1] In addition to immunoscore, other parameters of the immune response are investigated – mostly cellular immunity and the production of immunosuppressive and neoangiogenic markers. Vascular endothelial growth factor (VEGF) is the factor responsible for neoangiogenesis and it is being considered as a possible prognostic marker of disease progression. Transforming growth factor-beta (TGFbeta) is also neoangiogenic and a highly immunosuppressive factor as it suppresses the body’s natural immunity against tumours and is also being considered as another possible prognostic marker of disease progression.