Impact of Immunoscore on the Management of Stage II Colon Cancer Patients: A Physician Survey

Background: Adjuvant chemotherapy use in stage II colon cancer is controversial. Current prognostic risk factors do not take the tumor immune microenvironment into account. Consideration of the Immunoscore, which measures the host immune response at the tumor site, may assist clinicians in reducing...

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Autores principales:	Anup Kasi, Efrat Dotan, Graham M. Poage, Aurelie Catteau, Dewi Vernerey, Manju George, Afsaneh Barzi
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	colonic neoplasms oncologists surveys and questionnaires prognosis tumor microenvironment Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/014d65e1ad51487a812a8fdf489e7380
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spelling	oai:doaj.org-article:014d65e1ad51487a812a8fdf489e73802021-11-11T15:33:33ZImpact of Immunoscore on the Management of Stage II Colon Cancer Patients: A Physician Survey10.3390/cancers132154672072-6694https://doaj.org/article/014d65e1ad51487a812a8fdf489e73802021-10-01T00:00:00Zhttps://www.mdpi.com/2072-6694/13/21/5467https://doaj.org/toc/2072-6694Background: Adjuvant chemotherapy use in stage II colon cancer is controversial. Current prognostic risk factors do not take the tumor immune microenvironment into account. Consideration of the Immunoscore, which measures the host immune response at the tumor site, may assist clinicians in reducing adjuvant chemotherapy use in patients who are unlikely to benefit from it. This study sought to determine the potential clinical utility of the Immunoscore, via its effect on medical oncologists’ recommendations for management of patients with stage II colon cancer. Methods: De-identified vignettes of 10 patients with stage II colon cancer were presented to 25 practicing medical oncologists. Each participant completed surveys indicating recommendations for adjuvant chemotherapy and surveillance strategies. An educational session was subsequently conducted, and the same patient profiles were re-presented but included immunoscore results. Participants were again asked to provide their recommendations. A participant was counted as influenced if their responses were altered after immunoscore test results were provided. Results: All but one participant (96%) altered a management recommendation for ≥1 case. For individual cases, a mean of 55% (range, 40–80%) of participants altered their recommendations for adjuvant chemotherapy and/or surveillance. For the immunoscore-high cases (low-risk of recurrence), recommendations for adjuvant chemotherapy use decreased from 60% to 31%. Conclusions: These results indicate a willingness by oncologists to integrate immunoscore information into clinical practice recommendations. Incorporation of immunoscore data resulted in the reduction of nonvalue care in the simulated population. Confirmation in prospective studies is planned.Anup KasiEfrat DotanGraham M. PoageAurelie CatteauDewi VernereyManju GeorgeAfsaneh BarziMDPI AGarticlecolonic neoplasmsoncologistssurveys and questionnairesprognosistumor microenvironmentNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENCancers, Vol 13, Iss 5467, p 5467 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	colonic neoplasms oncologists surveys and questionnaires prognosis tumor microenvironment Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	colonic neoplasms oncologists surveys and questionnaires prognosis tumor microenvironment Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Anup Kasi Efrat Dotan Graham M. Poage Aurelie Catteau Dewi Vernerey Manju George Afsaneh Barzi Impact of Immunoscore on the Management of Stage II Colon Cancer Patients: A Physician Survey
description	Background: Adjuvant chemotherapy use in stage II colon cancer is controversial. Current prognostic risk factors do not take the tumor immune microenvironment into account. Consideration of the Immunoscore, which measures the host immune response at the tumor site, may assist clinicians in reducing adjuvant chemotherapy use in patients who are unlikely to benefit from it. This study sought to determine the potential clinical utility of the Immunoscore, via its effect on medical oncologists’ recommendations for management of patients with stage II colon cancer. Methods: De-identified vignettes of 10 patients with stage II colon cancer were presented to 25 practicing medical oncologists. Each participant completed surveys indicating recommendations for adjuvant chemotherapy and surveillance strategies. An educational session was subsequently conducted, and the same patient profiles were re-presented but included immunoscore results. Participants were again asked to provide their recommendations. A participant was counted as influenced if their responses were altered after immunoscore test results were provided. Results: All but one participant (96%) altered a management recommendation for ≥1 case. For individual cases, a mean of 55% (range, 40–80%) of participants altered their recommendations for adjuvant chemotherapy and/or surveillance. For the immunoscore-high cases (low-risk of recurrence), recommendations for adjuvant chemotherapy use decreased from 60% to 31%. Conclusions: These results indicate a willingness by oncologists to integrate immunoscore information into clinical practice recommendations. Incorporation of immunoscore data resulted in the reduction of nonvalue care in the simulated population. Confirmation in prospective studies is planned.
format	article
author	Anup Kasi Efrat Dotan Graham M. Poage Aurelie Catteau Dewi Vernerey Manju George Afsaneh Barzi
author_facet	Anup Kasi Efrat Dotan Graham M. Poage Aurelie Catteau Dewi Vernerey Manju George Afsaneh Barzi
author_sort	Anup Kasi
title	Impact of Immunoscore on the Management of Stage II Colon Cancer Patients: A Physician Survey
title_short	Impact of Immunoscore on the Management of Stage II Colon Cancer Patients: A Physician Survey
title_full	Impact of Immunoscore on the Management of Stage II Colon Cancer Patients: A Physician Survey
title_fullStr	Impact of Immunoscore on the Management of Stage II Colon Cancer Patients: A Physician Survey
title_full_unstemmed	Impact of Immunoscore on the Management of Stage II Colon Cancer Patients: A Physician Survey
title_sort	impact of immunoscore on the management of stage ii colon cancer patients: a physician survey
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/014d65e1ad51487a812a8fdf489e7380
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Impact of Immunoscore on the Management of Stage II Colon Cancer Patients: A Physician Survey

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