Ali Shamseddine, MD, Basile Cancer Institute at the American University of Beirut, Beirut, Lebanon, discusses the use of immunoscore in predicting the outcome of immunotherapy for patients with gastrointestinal (GI) cancer, as evaluated in a post-hoc analysis of the Averectal study (NCT03503630).The immunoscore has been validated in stage II colon cancer in determining whether a patient is high-risk or low-risk to decide whether to provide a patient with neoadjuvant chemotherapy. The immunoscore integrates the density of CD8+ and CD6+ T-cells from the tumour core and invasive margin to generate a low, medium or high immunoscore. Patients who exhibit a pathologic complete response (pCR) to adjuvant chemotherapy tend to have a high immunoscore. Dr. Shamseddine describes how the immunoscore could be used as a biomarker to select for patients with locally advanced rectal cancer who could benefit from immunotherapy in addition to neoadjuvant chemotherapy, achieve pCR and thus can ultimately be selected for the organ preservation strategy. This interview took place at the American Society of Clinical Oncology (ASCO) Gastrointestinal Cancers Symposium 2022.