# Galon 2006: the type, density and location of immune cells in colorectal tumours predict outcome

Source: https://onco.cc/key-papers/paper-galon-immune-contexture-colorectal-science-2006/  
OnCo record `paper-galon-immune-contexture-colorectal-science-2006` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Counting the T cells inside a bowel cancer and at its edge predicted whether the cancer would return better than the traditional stage did, the discovery behind the Immunoscore test.

## Summary

Galon and colleagues analysed immune cells in tumours from 415 patients with colorectal cancer using gene expression and tissue microarrays. A strong presence of adaptive immune cells, in particular CD3, CD8, CD45RO memory and granzyme B-positive cytotoxic T cells, in both the tumour centre and the invasive margin was associated with a much lower rate of early metastasis and longer survival, independently of and more strongly than the TNM stage. The finding led to the standardised Immunoscore, validated internationally in 2018.

## Fields

- Kind: Key paper
- Last checked: 2026-09-08
- Journal: Science
- Year: 2006
- DOI: 10.1126/science.1129139
- Authors: Galon J, Costes A, Sanchez-Cabo F, et al.
- Findings: Immune profiling of colorectal tumours from 415 patients by gene expression and tissue microarrays.; Tumours without signs of early metastatic invasion had higher densities of adaptive immune cells, especially memory and cytotoxic T cells.; High densities of CD3, CD8 and CD45RO cells in both the tumour centre and invasive margin predicted longer disease-free and overall survival, independently of TNM stage.
- What it means: This paper showed that the immune response to a cancer is part of its prognosis, not background noise, and it introduced the idea of the immune contexture that underlies both the Immunoscore and the biomarker work in immunotherapy.
- Caveats: A single-centre cohort at the time; the Immunoscore was validated in a later international study.; Immunoscore is not yet part of routine staging in most countries.

## Sources

- Full text (DOI): https://doi.org/10.1126/science.1129139

## Connected records

- roadmaps: [Colorectal cancer roadmap: from the adenoma-carcinoma sequence and the first screening trials to total mesorectal excision, oxaliplatin, RAS testing, immunotherapy for mismatch repair-deficient disease, ctDNA-guided treatment and organ preservation](https://onco.cc/roadmaps/colorectal-roadmap/)
- ideas: [Select microsatellite stable patients for immunotherapy by a measured immune biomarker, not by how many treatments they have already failed](https://onco.cc/ideas/idea-crc-mss-immunotherapy-by-biomarker-not-by-line/)
- cancers: [Colorectal cancer](https://onco.cc/cancers/colorectal/)
- technologies: [Histopathology & immunohistochemistry](https://onco.cc/technologies/histopathology-ihc/)
- pathways: [The cancer-immunity cycle](https://onco.cc/pathways/cancer-immunity-cycle/), [Tumour microenvironment (TME)](https://onco.cc/pathways/tumor-microenvironment/)
- terms: [Immune system](https://onco.cc/terms/immune-system/), [Immunohistochemistry (IHC)](https://onco.cc/terms/ihc/), [Prognosis](https://onco.cc/terms/prognosis/), [Tumour-infiltrating lymphocytes (TILs)](https://onco.cc/terms/tils/)
- key papers: [Thorsson 2018: the immune landscape of cancer across 10,000 tumours](https://onco.cc/key-papers/paper-thorsson-immune-landscape-of-cancer-immunity-2018/)

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