Knight, Katrina and Bigley, Christopher and Pennel, Kathryn and Hay, Jennifer and Maka, Noori and McMillan, Donald and Park, James and Roxburgh, Campbell and Edwards, Joanne (2024) The Glasgow Microenvironment Score: an exemplar of contemporary biomarker evolution in colorectal cancer. Journal of Pathology: Clinical Research, 10: e12385. ISSN 2056-4538
AI Summary:
Colorectal cancer remains a leading cause of mortality worldwide. The Glasgow Microenvironment Score (GMS) has been developed as a biomarker to predict patient outcomes and guide chemotherapy.AI Topics:
Colorectal cancer remains a leading cause of mortality worldwide. Significant variation in response to treatment and survival is evident among patients with similar stage disease. Molecular profiling has highlighted the heterogeneity of colorectal cancer but has had limited impact in daily clinical practice. Biomarkers with robust prognostic and therapeutic relevance are urgently required. Ideally, biomarkers would be derived from H&E sections used for routine pathological staging, have reliable sensitivity and specificity, and require minimal additional training. The biomarker targets would capture key pathological features with proven additive prognostic and clinical utility, such as the local inflammatory response and tumour microenvironment. The Glasgow Microenvironment Score (GMS), first described in 2014, combines assessment of peritumoural inflammation at the invasive margin with quantification of tumour stromal content. Using H&E sections, the Klintrup–Mäkinen (KM) grade is determined by qualitative morphological assessment of the peritumoural lymphocytic infiltrate at the invasive margin and tumour stroma percentage (TSP) calculated in a semi-quantitative manner as a percentage of stroma within the visible field. The resulting three prognostic categories have direct clinical relevance: GMS 0 denotes a tumour with a dense inflammatory infiltrate/high KM grade at the invasive margin and improved survival; GMS 1 represents weak inflammatory response and low TSP associated with intermediate survival; and GMS 2 tumours are typified by a weak inflammatory response, high TSP, and inferior survival. The prognostic capacity of the GMS has been widely validated while its potential to guide chemotherapy has been demonstrated in a large phase 3 trial cohort. Here, we detail its journey from conception through validation to clinical translation and outline the future for this promising and practical biomarker.
Knight, Katrina
Author
Knight, Katrina and Bigley, Christopher and Pennel, Kathryn and Hay, Jennifer and Maka, Noori and McMillan, Donald and Park, James and Roxburgh, Campbell and Edwards, Joanne (2024) The Glasgow Microenvironment Score: an exemplar of contemporary biomarker evolution in colorectal cancer. Journal of Pathology: Clinical Research, 10: e12385. ISSN 2056-4538
See full publications listBigley, Christopher
Author
Knight, Katrina and Bigley, Christopher and Pennel, Kathryn and Hay, Jennifer and Maka, Noori and McMillan, Donald and Park, James and Roxburgh, Campbell and Edwards, Joanne (2024) The Glasgow Microenvironment Score: an exemplar of contemporary biomarker evolution in colorectal cancer. Journal of Pathology: Clinical Research, 10: e12385. ISSN 2056-4538
See full publications listPennel, Kathryn A.F.
Author
Dolan, Ross D. and Pennel, Kathryn and Thompson, Joshua and McKenzie, Molly and Alexander, Peter and Richards, Colin and Black, Douglas and Abbass, Tanvir and Maka, Noori and McGovern, Josh and Roseweir, Antonia and McSorley, Stephen T. and Horgan, Paul G. and Roxburgh, Campbell and McMillan, Donald C. and Edwards, Joanne (2025) The relationship between tumour necrosis, systemic inflammation, body composition and survival in patients with colon cancer. BJC Reports, 3 (1): 7. ISSN 2731-9377
Pennel, Kathryn and Kurniawan, Ahmad and Al-Badran, Sara Samir Foad and Schubert Santana, Leonor and Quinn, Jean and Nixon, Colin and Hatthakarnkul, Phimmada and Maka, Noori and Roxburgh, Campbell and McMillan, Donald and Edwards, Joanne (2024) IL6 and IL6R as prognostic biomarkers in colorectal cancer. Biomolecules, 14 (12): 1629. ISSN 2218-273X
Galbraith, Norman J. and Quinn, Jean A. and Al-Badran, Sara Sf and Pennel, Kathryn A.F. and Hillson, Lily V.S. and Hatthakarnkul, Phimmada and McKenzie, Molly and Maka, Noori and Loi, Lynette and Frixou, Mikaela and Steele, Colin W. and Roxburgh, Campbell S. and Horgan, Paul G. and McMillan, Donald C. and Edwards, Joanne (2024) TAK1 expression is associated with increased PD-L1 and decreased cancer-specific survival in microsatellite-stable colorectal cancer. Translational Oncology, 48: 102064. ISSN 1944-7124
See full publications listHay, J.
Author
Fullerton, Josie L. and Hay, Jennifer and Bryant-Craig, Charlotte and Atkinson, Josephine and Smith, Douglas H. and Stewart, William (2024) Pediatric traumatic brain injury and microvascular blood-brain barrier pathology. JAMA Network Open, 7 (11): e2446767. ISSN 2574-3805
Knight, Katrina and Bigley, Christopher and Pennel, Kathryn and Hay, Jennifer and Maka, Noori and McMillan, Donald and Park, James and Roxburgh, Campbell and Edwards, Joanne (2024) The Glasgow Microenvironment Score: an exemplar of contemporary biomarker evolution in colorectal cancer. Journal of Pathology: Clinical Research, 10: e12385. ISSN 2056-4538
Hatthakarnkul, Phimmada and Pennel, Kathryn and Alexander, Peter and Van Wyk, Hester and Roseweir, Antonia and Inthagard, Jitwadee and Hay, Jennifer and Andersen, Ditte and Maka, Noori and Park, James and Roxburgh, Campbell and Thuwajit, Chanitra and McMillan, Donald and Edwards, Joanne (2024) Histopathological tumour microenvironment score independently predicts outcome in primary operable colorectal cancer. Journal of Pathology: Clinical Research, 10 (3): e12374. ISSN 2056-4538
See full publications listMaka, Noori
Author
Dolan, Ross D. and Pennel, Kathryn and Thompson, Joshua and McKenzie, Molly and Alexander, Peter and Richards, Colin and Black, Douglas and Abbass, Tanvir and Maka, Noori and McGovern, Josh and Roseweir, Antonia and McSorley, Stephen T. and Horgan, Paul G. and Roxburgh, Campbell and McMillan, Donald C. and Edwards, Joanne (2025) The relationship between tumour necrosis, systemic inflammation, body composition and survival in patients with colon cancer. BJC Reports, 3 (1): 7. ISSN 2731-9377
Pennel, Kathryn and Kurniawan, Ahmad and Al-Badran, Sara Samir Foad and Schubert Santana, Leonor and Quinn, Jean and Nixon, Colin and Hatthakarnkul, Phimmada and Maka, Noori and Roxburgh, Campbell and McMillan, Donald and Edwards, Joanne (2024) IL6 and IL6R as prognostic biomarkers in colorectal cancer. Biomolecules, 14 (12): 1629. ISSN 2218-273X
Galbraith, Norman J. and Quinn, Jean A. and Al-Badran, Sara Sf and Pennel, Kathryn A.F. and Hillson, Lily V.S. and Hatthakarnkul, Phimmada and McKenzie, Molly and Maka, Noori and Loi, Lynette and Frixou, Mikaela and Steele, Colin W. and Roxburgh, Campbell S. and Horgan, Paul G. and McMillan, Donald C. and Edwards, Joanne (2024) TAK1 expression is associated with increased PD-L1 and decreased cancer-specific survival in microsatellite-stable colorectal cancer. Translational Oncology, 48: 102064. ISSN 1944-7124
See full publications listMcMillan, D.C.
Author
Bradley, Nicholas A. and Walter, Amy and Sankey, Chiara and Wilson, Alasdair and Siddiqui, Tamim and Roxburgh, Campbell D. and McMillan, Donald C. and Guthrie, Graeme J.K. (2025) Longitudinal association between statins and changes in CT derived body composition in patients with abdominal aortic aneurysm. Journal of Cachexia, Sarcopenia and Muscle, 16 (2). ISSN 2190-5991
Thompson, Joshua J. and MacLeod, Nicholas and Will, Sarah and O'Rourke, Fraser and McGovern, Josh and Roxburgh, Campbell and Edwards, Joanne and Dolan, Ross D. and McMillan, Donald C. (2025) The prognostic value of a laboratory cachexia score (LCAS) defined by LDH, CRP and albumin in patients with advanced lung cancer. BMC Cancer, 25: 543. ISSN 1471-2407
Dolan, Ross D. and Pennel, Kathryn and Thompson, Joshua and McKenzie, Molly and Alexander, Peter and Richards, Colin and Black, Douglas and Abbass, Tanvir and Maka, Noori and McGovern, Josh and Roseweir, Antonia and McSorley, Stephen T. and Horgan, Paul G. and Roxburgh, Campbell and McMillan, Donald C. and Edwards, Joanne (2025) The relationship between tumour necrosis, systemic inflammation, body composition and survival in patients with colon cancer. BJC Reports, 3 (1): 7. ISSN 2731-9377
See full publications listPark, James H.
Author
Knight, Katrina and Bigley, Christopher and Pennel, Kathryn and Hay, Jennifer and Maka, Noori and McMillan, Donald and Park, James and Roxburgh, Campbell and Edwards, Joanne (2024) The Glasgow Microenvironment Score: an exemplar of contemporary biomarker evolution in colorectal cancer. Journal of Pathology: Clinical Research, 10: e12385. ISSN 2056-4538
Hatthakarnkul, Phimmada and Pennel, Kathryn and Alexander, Peter and Van Wyk, Hester and Roseweir, Antonia and Inthagard, Jitwadee and Hay, Jennifer and Andersen, Ditte and Maka, Noori and Park, James and Roxburgh, Campbell and Thuwajit, Chanitra and McMillan, Donald and Edwards, Joanne (2024) Histopathological tumour microenvironment score independently predicts outcome in primary operable colorectal cancer. Journal of Pathology: Clinical Research, 10 (3): e12374. ISSN 2056-4538
Pennel, Kathryn A.F. and Hatthakarnkul, Phimmada and Wood, Colin S. and Lian, Guang-Yu and Al-Badran, Sara and Quinn, Jean A. and Legrini, Assya and Inthagard, Jitwadee and Alexander, Peter G. and van Wyk, Hester and Kurniawan, Ahmad and Hashmi, Umar and Gillespie, Michael A. and Mills, Megan and Ammar, Aula and Hay, Jennifer and Andersen, Ditte and Nixon, Colin and Rebus, Selma and Chang, David K. and Kelly, Caroline and Harkin, Andrea and Graham, Janet and Church, David and Tomlinson, Ian and Saunders, Mark and Iveson, Tim and Lannagan, Tamsin R. M. and Jackstadt, Rene and Maka, Noori and Horgan, Paul G. and Roxburgh, Campbell S. D. and Sansom, Owen J. and McMillan, Donald C. and Steele, Colin W. and Jamieson, Nigel B. and Park, James H. and Roseweir, Antonia K. and Edwards, Joanne (2024) JAK/STAT3 represents a therapeutic target for colorectal cancer patients with stromal-rich tumors. Journal of Experimental and Clinical Cancer Research, 43: 64. ISSN 1756-9966
See full publications listRoxburgh, Campbell S. D.
Author
Bradley, Nicholas A. and Walter, Amy and Sankey, Chiara and Wilson, Alasdair and Siddiqui, Tamim and Roxburgh, Campbell D. and McMillan, Donald C. and Guthrie, Graeme J.K. (2025) Longitudinal association between statins and changes in CT derived body composition in patients with abdominal aortic aneurysm. Journal of Cachexia, Sarcopenia and Muscle, 16 (2). ISSN 2190-5991
Thompson, Joshua J. and MacLeod, Nicholas and Will, Sarah and O'Rourke, Fraser and McGovern, Josh and Roxburgh, Campbell and Edwards, Joanne and Dolan, Ross D. and McMillan, Donald C. (2025) The prognostic value of a laboratory cachexia score (LCAS) defined by LDH, CRP and albumin in patients with advanced lung cancer. BMC Cancer, 25: 543. ISSN 1471-2407
Dolan, Ross D. and Pennel, Kathryn and Thompson, Joshua and McKenzie, Molly and Alexander, Peter and Richards, Colin and Black, Douglas and Abbass, Tanvir and Maka, Noori and McGovern, Josh and Roseweir, Antonia and McSorley, Stephen T. and Horgan, Paul G. and Roxburgh, Campbell and McMillan, Donald C. and Edwards, Joanne (2025) The relationship between tumour necrosis, systemic inflammation, body composition and survival in patients with colon cancer. BJC Reports, 3 (1): 7. ISSN 2731-9377
See full publications listEdwards, J.
Author
Thompson, Joshua J. and MacLeod, Nicholas and Will, Sarah and O'Rourke, Fraser and McGovern, Josh and Roxburgh, Campbell and Edwards, Joanne and Dolan, Ross D. and McMillan, Donald C. (2025) The prognostic value of a laboratory cachexia score (LCAS) defined by LDH, CRP and albumin in patients with advanced lung cancer. BMC Cancer, 25: 543. ISSN 1471-2407
Dolan, Ross D. and Pennel, Kathryn and Thompson, Joshua and McKenzie, Molly and Alexander, Peter and Richards, Colin and Black, Douglas and Abbass, Tanvir and Maka, Noori and McGovern, Josh and Roseweir, Antonia and McSorley, Stephen T. and Horgan, Paul G. and Roxburgh, Campbell and McMillan, Donald C. and Edwards, Joanne (2025) The relationship between tumour necrosis, systemic inflammation, body composition and survival in patients with colon cancer. BJC Reports, 3 (1): 7. ISSN 2731-9377
Pennel, Kathryn and Kurniawan, Ahmad and Al-Badran, Sara Samir Foad and Schubert Santana, Leonor and Quinn, Jean and Nixon, Colin and Hatthakarnkul, Phimmada and Maka, Noori and Roxburgh, Campbell and McMillan, Donald and Edwards, Joanne (2024) IL6 and IL6R as prognostic biomarkers in colorectal cancer. Biomolecules, 14 (12): 1629. ISSN 2218-273X
See full publications listAvailable under License Creative Commons Attribution.
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