肿瘤免疫细胞影响免疫检查点抑制剂（ICIs）的功效，许多努力旨在确定肿瘤免疫微环境的特征，以预测pMMR /微卫星稳定（MSS）转移性结直肠癌（mCRC）中ICIs的受益。我们通过评估AtezoTRIBE研究入组mCRC患者的肿瘤样本中的肿瘤浸润淋巴细胞（TILs），免疫得分，免疫得分-IC和程序性死亡配体-1（PD-L1）表达，表征了肿瘤免疫细胞浸润，并旨在评估这些特征的预后和预测价值。218名入组患者中，成功测试了181个（83％），77个（35％），157个（72％）和162个（74％）规格，TILs，免疫得分，免疫得分- IC和PD-L1表达分别为69（38％），45（58％），50（32％）和21（13％）。观察到TILs与免疫得分或免疫得分-IC的一致性很差（Cohen的K <0.20）。在pMMR人群中，与免疫得分低（16.4 vs 12.2个月; HR：0.55，95％CI：0.30至0.99; p = 0.049）和免疫得分-IC低（14.8 vs 11.5个月; HR：0.55，95％CI：0.35至0.85; p = 0.007）分组相比，免疫得分高和免疫得分-IC高组报告了更长的无进展生存（PFS），并且存在治疗方案和免疫得分-IC之间的显著交互作用（p交互：0.006），并有免疫得分的趋势（p交互：0.13）。根据TILs和PD-L1表达，未显示出PFS差异。总体人群报告了一致的结果。通过免疫得分-IC或免疫得分的数字评估，鉴定了pMMR mCRC患者的亚组，在ICIs的前期治疗中获得了更多的益处。免疫得分-IC是ICIs受益的最有前途的预测因素。©作者（或其雇主）2023。在CC BY-NC下允许再次使用。不进行商业再利用。由BMJ出版。

Tumor immune cells influence the efficacy of immune-checkpoint inhibitors (ICIs) and many efforts aim at identifying features of tumor immune microenvironment able to predict benefit from ICIs in proficient mismatch repair (pMMR)/microsatellite stable (MSS) metastatic colorectal cancer (mCRC).We characterized tumor immune cell infiltrate, by assessing tumor-infiltrating lymphocytes (TILs), Immunoscore, Immunoscore-IC, and programmed death ligand-1 (PD-L1) expression in tumor samples of patients with mCRC enrolled in the AtezoTRIBE study, a phase II randomized trial comparing FOLFOXIRI/bevacizumab/atezolizumab to FOLFOXIRI/bevacizumab, with the aim of evaluating the prognostic and predictive value of these features.Out of 218 patients enrolled, 181 (83%), 77 (35%), 157 (72%) and 162 (74%) specimens were successfully tested for TILs, Immunoscore, Immunoscore-IC and PD-L1 expression, respectively, and 69 (38%), 45 (58%), 50 (32%) and 21 (13%) tumors were classified as TILs-high, Immunoscore-high, Immunoscore-IC-high and PD-L1-high, respectively. A poor agreement was observed between TILs and Immunoscore or Immunoscore-IC (K of Cohen <0.20). In the pMMR population, longer progression-free survival (PFS) was reported for Immunoscore-high and Immunoscore-IC-high groups compared with Immunoscore-low (16.4 vs 12.2 months; HR: 0.55, 95% CI: 0.30 to 0.99; p=0.049) and Immunoscore-IC-low (14.8 vs 11.5 months; HR: 0.55, 95% CI: 0.35 to 0.85; p=0.007), respectively, with a significant interaction effect between treatment arms and Immunoscore-IC (p for interaction: 0.006) and a trend for Immunoscore (p for interaction: 0.13). No PFS difference was shown according to TILs and PD-L1 expression. Consistent results were reported in the overall population.The digital evaluation of tumor immune cell infiltrate by means of Immunoscore-IC or Immunoscore identifies the subset of patients with pMMR mCRC achieving more benefit from the addition of the anti-PD-L1 to the upfront treatment. Immunoscore-IC stands as the most promising predictor of benefit from ICIs.© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.