Abstract
Gastrointestinal (GI) cancers contribute significantly to the worldwide cancer burden. Pathologic evaluation is indispensable for the estimation of prognosis and therapeutic strategy. At present, immunotherapies are evolving into efficient therapeutic approaches, which are accompanied by the need for biomarkers to predict therapy response. In colorectal cancers, the only predictive biomarker for Food and Drug Administration-approved immunotherapy is the mismatch repair status. Besides, pathogenic polymerase epsilon mutations, tumor mutational burden, neoantigen load, and features of the immune contexture could soon find their way into clinical routine. Furthermore, in colorectal cancer, the Immunoscore, which is defined by the amount of CD3+ and CD8+ T-cells in the tumor center as well as at the infiltrative margin, might supplement the TNM system in the future (as TNM-Immune). This immunologic biomarker was shown to be impressively prognostic and predictive in colorectal cancer. In conclusion, there is increasing evidence of immunologic as well as predictive biomarkers for immunotherapies in GI cancers. Nevertheless, future progress is necessary for the variety of current advances to be implemented in clinical care.