Thesis etd-02182025-161205 |
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Thesis type
Tesi di laurea magistrale LM6
URN
etd-02182025-161205
Thesis title
Studio del ruolo predittivo delle cellule immunitarie circolanti nel trattamento di prima linea con atezolizumab e bevacizumab per il carcinoma epatocellulare avanzato (aHCC)
Department
RICERCA TRASLAZIONALE E DELLE NUOVE TECNOLOGIE IN MEDICINA E CHIRURGIA
Course of study
MEDICINA E CHIRURGIA
Supervisors
.
relatore Prof. Masi, Gianluca
correlatore Dott.ssa Salani, Francesca
correlatore Dott.ssa Salani, Francesca
Keywords
- aHCC
- atezolizumab
- bevacizumab
- CD16+ monocytes
- CD4-CD8- T lymphocytes
- CD4+LAG+ T lymphocytes
- CD8+LAG+ T lymphocytes
- flow cytometry
- primary progressors
Graduation session start date
25/03/2025
Availability
Withheld
Release date
25/03/2028
Abstract (Inglese)
Abstract (Italiano)
La combinazione atezolizumab/bevacizumab è uno dei gold standard per il trattamento sistemico dell’epatocarcinoma avanzato (aHCC). L’eterogeneità della risposta dei pazienti alle combinazioni contenenti immunoterapici necessita la ricerca di fattori che possano indirizzare la terapia precocemente rispetto alla prima rivalutazione radiologica. Il seguente studio ha confermato fattori predittivi clinici noti dagli studi registrativi e identificato fattori immunitari circolanti analizzando le concentrazioni di subpopolazioni cellulari all’analisi citofluorimetrica. Concentrazioni maggiori di linfociti T CD8+LAG+, T CD4-CD8- e di monociti CD16+ sembrano predire un outcome peggiore in termini di sopravvivenza mediana globale. Livelli significativamente maggiori dell’indice neutrofili/linfociti e delle concentrazioni di linfociti T CD4+LAG+ e T CD8+LAG+ nei pazienti rispetto alla coorte di sani sembrano indicare un microambiente circolante immunosoppressivo caratterizzante il paziente con HCC.
Atezolizumab/bevacizumab combination is one of the gold standard systemic treatments for advanced hepatocellular carcinoma (aHCC). The heterogeneity of patients' response to immunotherapy supports the need for predictive factors of early treatment outcome. This study confirmed clinical predictors of atezolizumab/bevacizumab outcome in a single institution real-word cohort and identified putative predictive factors by analyzing the concentrations of circulating cell subpopulations by flow cytometric analysis. Higher concentrations of CD8+LAG+ or CD4-CD8- T lymphocytes and CD16+ monocytes appear to predict a worse outcome in terms of median overall survival. Higher neutrophil-to-lymphocyte ratio and higher concentrations of CD4+LAG+ or CD8+LAG+ T lymphocytes in patients compared to healthy controls cohort constitute a first evidence of the specificity of the immune profile of HCC patients.
Atezolizumab/bevacizumab combination is one of the gold standard systemic treatments for advanced hepatocellular carcinoma (aHCC). The heterogeneity of patients' response to immunotherapy supports the need for predictive factors of early treatment outcome. This study confirmed clinical predictors of atezolizumab/bevacizumab outcome in a single institution real-word cohort and identified putative predictive factors by analyzing the concentrations of circulating cell subpopulations by flow cytometric analysis. Higher concentrations of CD8+LAG+ or CD4-CD8- T lymphocytes and CD16+ monocytes appear to predict a worse outcome in terms of median overall survival. Higher neutrophil-to-lymphocyte ratio and higher concentrations of CD4+LAG+ or CD8+LAG+ T lymphocytes in patients compared to healthy controls cohort constitute a first evidence of the specificity of the immune profile of HCC patients.
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