Combined assessment of peritumoral Th1/Th2 polarization and peripheral immunity as a new biomarker in the prediction of BCG response in patients with high-risk NMIBC
| Autor: | Maria Gonzalez Cao, Sònia Pedreño-López, Cristina Teixidó, Roberto Martinez, Gustavo Tapia, Silvia De Muga, Alba Hernández, Julià Blanco, Bonaventura Clotet, Luis Ibarz, Cecilia Cabrera, Elisabet García, Victor Urrea |
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| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
Oncology lcsh:Immunologic diseases. Allergy medicine.medical_specialty Immunology GATA-3 T-bet nmibc lcsh:RC254-282 Th2 polarization NLR 03 medical and health sciences gata-3 0302 clinical medicine Immunity Internal medicine Immunology and Allergy Effective treatment Medicine In patient NMIBC Original Research Bladder cancer business.industry Bcg immunotherapy t-bet medicine.disease lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens nlr Peripheral 030104 developmental biology bcg immunotherapy 030220 oncology & carcinogenesis Biomarker (medicine) biomarker business lcsh:RC581-607 BCG immunotherapy |
| Zdroj: | OncoImmunology r-IGTP. Repositorio Institucional de Producción Científica del Instituto de Investigación Germans Trias i Pujol instname OncoImmunology, Vol 8, Iss 8 (2019) |
| ISSN: | 2162-4011 |
| Popis: | Intravesical Bacille Calmette-Guerin (BCG) remains the most effective treatment for high-risk non-muscle-invasive bladder cancer (NMIBC), unfortunately there is no validated biomarker to predict clinical outcome. Here we tried to explore the possibility that a combination of the density of peritumoral infiltrating cells (Th1, Th2 and PD-L1) and the composition of peripheral immune cells (neutrophil and lymphocyte counts) could generate a more reliable prognostic biomarker. Twenty-two patients with high-risk NMIBC treated with BCG (10 BCG nonresponders and 12 BCG responders) were selected. BCG responders had significantly lower level of peritumoral T-bet(+) cells with an associated higher GATA-3(+)/T-bet(+) ratio (p = 0.04, p = 0.02, respectively). Furthermore, the immune polarization in tissue (GATA-3(+)/T-bet(+) ratio) adjusted for the systemic inflammation (neutrophil-to-lymphocyte ratio) showed a significantly higher association with the BCG response (p = 0.004). A survival analysis demonstrated prolonged recurrence-free survival (RFS) in patients with a lower T-bet(+)/Lymphocyte ratio and higher GTR/NLR (p = 0.01). No association was observed between peritumoral PD-L1(+) expression and the BCG response. In conclusion, alterations in overall immune function, both local and systemic, may influence the therapeutic response to BCG, therefore a combined analysis of tumoral (Th2/Th1 ratio) and peripheral (NLR) immune composition prior to treatment may be a promising approach to predict the BCG response in high-risk NMIBC patients. |
| Databáze: | OpenAIRE |
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