. 2021 Mar 28;26(8):651–659. doi: 10.1002/onco.13738

Table 2.

Selected genomic tests for risk assessment in CRC

Test	Test description and uses	Relevant clinical trials
Oncotype DX Colon [10, 11, 12, 13]	12‐gene genomic test (7 cancer‐related, 5 reference); validated for use in stage II MMR‐P and stage III A/B colon cancers; used to estimate recurrence risk (low, intermediate, high) and help guide treatment decisions; not predictive of adjuvant chemotherapy benefit	Validation studies confirm Recurrence Score (0–100); result predicts risk for local recurrence (QUASAR, CALGB 9581, NSABP C‐07, SUNRISE)
Immunoscore Colon [14, 15, 16, 17, 18, 19, 20]	Image analysis–based risk assessment tool targeting CD3+ and CD8+ cells and examining host immune response at the tumor site; intended for use adjunctively with TNM classification	In patients with stage II disease Immunoscore predicted a high‐risk subgroup (Immunoscore Low) with increased recurrence at 5 years (23% vs. 8%); suggested 7 of 10 high‐risk patients with stage II disease might be spared chemotherapy Patients with stage III disease with Immunoscore High status had significantly better DFS (HR = 0.59; p = .0013), whereas 1 of 2 low‐risk (T1‐3/N1) patients with Immunoscore Low status had significantly worse 3‐year DFS (78% vs. 92%)

Test

Test description and uses

Relevant clinical trials

Oncotype DX Colon [10, 11, 12, 13]

12‐gene genomic test (7 cancer‐related, 5 reference); validated for use in stage II MMR‐P and stage III A/B colon cancers; used to estimate recurrence risk (low, intermediate, high) and help guide treatment decisions; not predictive of adjuvant chemotherapy benefit

Validation studies confirm Recurrence Score (0–100); result predicts risk for local recurrence (QUASAR, CALGB 9581, NSABP C‐07, SUNRISE)

Immunoscore Colon [14, 15, 16, 17, 18, 19, 20]

Image analysis–based risk assessment tool targeting CD3+ and CD8+ cells and examining host immune response at the tumor site; intended for use adjunctively with TNM classification

In patients with stage II disease Immunoscore predicted a high‐risk subgroup (Immunoscore Low) with increased recurrence at 5 years (23% vs. 8%); suggested 7 of 10 high‐risk patients with stage II disease might be spared chemotherapy

Patients with stage III disease with Immunoscore High status had significantly better DFS (HR = 0.59; p = .0013), whereas 1 of 2 low‐risk (T1‐3/N1) patients with Immunoscore Low status had significantly worse 3‐year DFS (78% vs. 92%)

Abbreviations: CRC, colorectal cancer; DFS, disease‐free survival; MMR‐P, mismatch repair proficient; TNM, tumor, node, metastasis.