Thesis etd-10292021-120834 |
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Thesis type
Tesi di specializzazione (5 anni)
Author
PAOLIERI, FEDERICO
URN
etd-10292021-120834
Thesis title
Identificazione di fattori predittivi di risposta a inibitori dei checkpoint immunitari nel carcinoma uroteliale metastatico: focus su criteri clinici, laboratoristici e prospettive future
Department
RICERCA TRASLAZIONALE E DELLE NUOVE TECNOLOGIE IN MEDICINA E CHIRURGIA
Course of study
ONCOLOGIA MEDICA
Supervisors
relatore Prof.ssa Cremolini, Chiara
relatore Dott. Galli, Luca
relatore Dott. Galli, Luca
Keywords
- biomarkers
- carcinoma uroteliale
- checkpoint inhibitors
- fattori predittivi
- immunoterapia
- predictive factors
- urothelial carcinoma
Graduation session start date
16/11/2021
Availability
Withheld
Release date
16/11/2091
Summary
La chemioterapia a base di platino è stata per anni l'unico trattamento disponibile per il carcinoma uroteliale metastatico e pazienti in progressione durante o dopo trattamento chemioterapico di prima linea presentavano limitate opzioni terapeutiche e una scarsa sopravvivenza globale. Più recentemente farmaci immunoterapici che agiscono a livello del chekpoint immunitario (anti PD-1/PD-L1) si sono dimostrati attivi in questo gruppo di pazienti e sono stati introdotti nella pratica clinica. Tuttavia, solo il 20-30% dei pazienti risponde al tattamento immunoterapico. Marcatori predittivi di risposta al trattamento con anti-PD1/PD-L1 sono ancora oggetto di studio. Scopo di questo studio è valutare, in una corte di pazienti affetti da carcinoma uroteliale metastatico, fattori clinici e laboratoristici che possano predire risposta al trattamento immunoterapico.
Cytotoxic chemotherapy has been the only systemic treatment of locally advanced and metastatic urothelial carcinoma (mUC) for decades. Overall survival in patients with advanced disease who have progressed on or recurred after receiving first-line platinum-based chemotherapy remains poor. More recently antibodies targeting programmed cell death-1 (PD-1) or its ligand, programmed cell death ligand 1 (PD-L1), have been approved for patients with locally advanced or metastatic urothelial carcinoma that had recurred following platinum-containing chemotherapy. Nevertheless, only 20–30% of mUC patients respond to ICIs (immune checkpoint inhibitors), and an even smaller proportion achieve durable responses lasting ≥2 years. Predictive biomarkers that correlate with response to ICIs are lacking. Aim of this study is to evaluate clinical and laboratoristic factors that may predict response to immunotherapy.
Cytotoxic chemotherapy has been the only systemic treatment of locally advanced and metastatic urothelial carcinoma (mUC) for decades. Overall survival in patients with advanced disease who have progressed on or recurred after receiving first-line platinum-based chemotherapy remains poor. More recently antibodies targeting programmed cell death-1 (PD-1) or its ligand, programmed cell death ligand 1 (PD-L1), have been approved for patients with locally advanced or metastatic urothelial carcinoma that had recurred following platinum-containing chemotherapy. Nevertheless, only 20–30% of mUC patients respond to ICIs (immune checkpoint inhibitors), and an even smaller proportion achieve durable responses lasting ≥2 years. Predictive biomarkers that correlate with response to ICIs are lacking. Aim of this study is to evaluate clinical and laboratoristic factors that may predict response to immunotherapy.
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