Immune and stromal classification of colorectal cancer is associated with molecular subtypes and relevant for precision immunotherapy
Published version of a preprint
Abstract
Purpose: The tumor microenvironment is formed by many distinct and interacting cell populations, and its composition may predict patients' prognosis and response to therapies. Colorectal cancer is a heterogeneous disease in which immune classifications and four consensus molecular subgroups (CMS) have been described. Our aim was to integrate the composition of the tumor microenvironment with the consensus molecular classification of colorectal cancer. Experimental Design: We retrospectively analyzed the composition and the functional orientation of the immune, fibroblastic, and angiogenic microenvironment of 1,388 colorectal cancer tumors from three independent cohorts using transcriptomics. We validated our findings using immunohistochemistry. Results: We report that colorectal cancer molecular subgroups and microenvironmental signatures are highly correlated. Out of the four molecular subgroups, two highly express immune-specific genes. The good-prognosis microsatellite instable–enriched subgroup (CMS1) is characterized by overexpression of genes specific to cytotoxic lymphocytes. In contrast, the poor-prognosis mesenchymal subgroup (CMS4) expresses markers of lymphocytes and of cells of monocytic origin. The mesenchymal subgroup also displays an angiogenic, inflammatory, and immunosuppressive signature, a coordinated pattern that we also found in breast (n = 254), ovarian (n = 97), lung (n = 80), and kidney (n = 143) cancers. Pathologic examination revealed that the mesenchymal subtype is characterized by a high density of fibroblasts that likely produce the chemokines and cytokines that favor tumor-associated inflammation and support angiogenesis, resulting in a poor prognosis. In contrast, the canonical (CMS2) and metabolic (CMS3) subtypes with intermediate prognosis exhibit low immune and inflammatory signatures. Conclusions: The distinct immune orientations of the colorectal cancer molecular subtypes pave the way for tailored immunotherapies. Clin Cancer Res; 22(16); 4057–66. ©2016 AACR.
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CMS4 tumors have stromal enrichment.
“A second outstanding and undisputed hallmark of CMS4 tumors is their stromal enrichment, which emerged both from transcriptomic signature (2) and histologic analyses (29).”
From Clinical Challenges of Consensus Molecular Subtype CMS4 Colon Cancer in the Era of Precision Medicine (2024) · cites this paper as [2]
Cancer cells and CAF-derived factors, including TGFβ and PDGF, promote endothelial cell infiltration and angiogenesis, which are hallmarks of CMS4.
“both cancer cells and CAF-derived factors, including TGFβ and PDGF, are expected to promote endothelial cell infiltration and angiogenesis, again hallmarks of CMS4 (2).”
From Clinical Challenges of Consensus Molecular Subtype CMS4 Colon Cancer in the Era of Precision Medicine (2024) · cites this paper as [2]
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- Authors
- Becht, E., de Reyniès, A., Giraldo, N. A., Pilati, C., Buttard, B., Lacroix, L., Selves, J., Sautès-Fridman, C., Laurent-Puig, P., & Fridman, W. H.
- Affiliations
- 1INSERM UMR_S 1138, Cancer, Immune Control and Escape, Cordeliers Research Centre, Paris, France.
- 4Programme Cartes d'Identité des Tumeurs, Ligue Nationale Contre le Cancer, Paris, France.
- Inserm (FR)
- 6Centre de Recherche en Cancérologie de Toulouse, Unité Mixte de Recherche, 1037 INSERM - Université Toulouse III, Toulouse, France.
- 2Université Paris Descartes, Paris, France.
- Corresponding author
- Fridman, Wolf Herman
- Venue
- Clinical Cancer Research
- Published
- 2016-08-14
- Volume
- 22
- Issue
- 16
- Pages
- 4057-4066
- ISSN
- 1078-0432 (ISSN-L)
- 1557-3265
- OpenAlex
- W2310046094
- Cited by
- 590
- References
- 43
- Citations by year
- 2026: 28 · 2025: 30 · 2024: 52 · 2023: 67 · 2022: 71 · 2021: 99 · 2020: 68 · 2019: 70 · 2018: 49 · 2017: 41 · 2016: 11
- FWCI
- 30.57
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Cancer Research (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Agence Nationale de la Recherche (ANR-10-LABX-0015)
- Topics
- Health Sciences › Medicine › Oncology › Colorectal Cancer Treatments and Studies
- Health Sciences › Medicine › Oncology › Cancer Immunotherapy and Biomarkers
- Health Sciences › Medicine › Pathology and Forensic Medicine › Genetic factors in colorectal cancer
- Keywords
- colorectal cancer, consensus molecular subtypes, tumor microenvironment, immune cell composition, stromal fibroblasts, tumor-associated macrophages, angiogenesis, tumor-infiltrating lymphocytes, mesenchymal subtype, microsatellite instability, immunotherapy response, cancer immunotherapy, transcriptomics, cross-cancer analysis
- MeSH terms
- Cancer-Associated Fibroblasts, Humans, Immunotherapy, Neovascularization, Pathologic, Biomarkers, Tumor, Colorectal Neoplasms, Cluster Analysis, Stromal Cells, Gene Expression Profiling, Cell Line, Tumor, Precision Medicine, Tumor Microenvironment
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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