Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy.
Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy.
Endocrine. 2019 Apr;64(1):122-129. doi: 10.1007/s12020-019-01865-5. Epub 2019 Feb 14.
Anaplastic thyroid carcinoma (ATC) is a rare, highly aggressive form of thyroid cancer (TC) characterized by an aggressive behavior and poor prognosis, resulting in patients' death within a year. Standard treatments, such as chemo and radiotherapy, as well as tyrosine kinase inhibitors, are ineffective for ATC treatment. Cancer immunotherapy is one of the most promising research area in oncology. The PD-1/PD-L1 axis is of particular interest, in light of promising data showing a restoration of host immunity against tumors, with the prospect of long-lasting remissions.
In this study, we evaluated PD-L1 expression in a large series of TCs (20 cases) showing a progressive dedifferentiation of the thyroid tumor from well differentiated TC to ATC, employing two different antibodies [R&D Systems and VENTANA PD-L1 (SP263) Rabbit Monoclonal Primary Antibody]. We also tested the anti PD-L1 mAb in an in vivo animal model.
We found that approximately 70-90% of ATC cases were positive for PD-L1 whereas normal thyroid and differentiated TC were negative. Moreover, all analyzed cases presented immunopositive staining in the endothelium of vessels within or in close proximity to the tumor, while normal thyroid vessels were negative. PD-L1 mAb was also effective in inhibiting ATC growth in an in vivo model.
These data suggest that immunotherapy may be a promising treatment specific for ATC suggesting the need to start with clinical TRIALs.
间变性甲状腺癌(ATC)是一种罕见的、高度侵袭性的甲状腺癌(TC)形式,其特征为侵袭性行为和不良预后,导致患者在一年内死亡。标准治疗方法,如化疗和放疗,以及酪氨酸激酶抑制剂,对 ATC 的治疗无效。癌症免疫疗法是肿瘤学中最有前途的研究领域之一。PD-1/PD-L1 轴特别引人注目,因为有希望的数据表明恢复了宿主对肿瘤的免疫力,有望实现持久缓解。
在这项研究中,我们使用两种不同的抗体[R&D 系统和 VENTANA PD-L1(SP263)兔单克隆原发性抗体],在从分化良好的 TC 到 ATC 的甲状腺肿瘤进行进行性去分化的大型 TC 系列(20 例)中评估 PD-L1 的表达。我们还在体内动物模型中测试了抗 PD-L1 mAb。
我们发现大约 70-90%的 ATC 病例 PD-L1 阳性,而正常甲状腺和分化型 TC 则为阴性。此外,所有分析的病例在肿瘤内或附近的血管内皮均呈现免疫阳性染色,而正常甲状腺血管则为阴性。PD-L1 mAb 也能有效抑制体内 ATC 生长的模型。
这些数据表明,免疫疗法可能是一种针对 ATC 的有前途的治疗方法,表明需要开始进行临床试验。