Abstract
AB030. Metabolic profiles and clinical outcome in patients with thymic epithelial tumors
Rocco Morra1,2, Michele Francesco Di Tolla3, Erica Pietroluongo1, Pietro De Placido1, Margaret Ottaviano2,3,4, Antonio D’Ambrosio1, Aldo Caltavituro1, Vitoantonio Del Deo5, Marianna Tortora4, Anna Maria Malfitano3, Vittoria D’Esposito3, Sara Pellegrino6, Maria Rosaria Saponaro1, Angelo Luciano1, Sabino De Placido1,2,3,4, Pietro Formisano2, Roberto Bianco1, Alberto Servetto1, Giovannella Palmieri4, Mario Giuliano1,2,3,4
1Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy;
2Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Naples, Italy;
3Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy;
4Rare Tumors Coordinating Center of Campania Region (CRCTR), Naples, Italy;
5Azienda Ospedaliera Universitaria Federico II di Napoli, Naples, Italy;
6Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
Correspondence to: Rocco Morra, MD, PhD. Experimental Clinical Abdominal Oncology Unit, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, via Mariano Semmola 52, Naples 80131, Italy; Department of Clinical Medicine and Surgery, University Federico II, via Sergio Pansini 5, Naples 80131, Italy. Email: rocco.mor4@gmail.com.
Background: Thymic epithelial tumors (TETs) are rare diseases, frequently associated with autoimmune disorders (AD). The pathophysiological correlation between TETs and AD is still not totally explained. Recent studies suggest that the alterations of metabolic profiles are associated with poor prognosis in multiple tumor types. This study aims to evaluate the correlation of metabolic profiles and long-term outcome in patients with TETs.
Methods: From May 2019 to March 2024, consecutive TETs patients were recruited at Rare Tumors Coordinating Center of Campania Region. Serological levels of ten energy metabolism factors, from peripheral blood, were evaluated, one time in each patient, at various timepoints during disease course, using preformed kits by Bioplex Pro. Based on the optimal cut-off values calculated by the survival cut-point algorithm, patients were classified into low and high score, to identify those achieving a better overall survival (OS). Log-rank test, univariate and multivariate Cox regression analyses were performed. The survival R package was used for statistical analyses.
Results: Among the 45 patients enrolled, 20 (44.4%) were male. Tumor histology included 35 (77.8%) thymoma and 10 (22.2%) thymic carcinomas. AD was detected in 32 TET patients (71.1%) and 28 (62.2%) were under corticosteroid treatment. At the time of analysis, 28 (66.2%) were alive and 17 (37.8%) patients deceased. In the univariate analysis, visfatin levels significantly predicts better OS [high vs. low hazard ratio (HR) 0.146, 95% confidence interval (CI): 0.033–0.643, P=0.01]; while we observe a trend for PAI-1 (high vs. low HR 0.383, 95% CI: 0.141–1.04, P=0.059) and GLP-1 (high vs. low HR 2.405, 95% CI: 0.882–6.553, P=0.09). Multivariate Cox analysis was performed adjusting for age, Eastern Cooperative Oncology Group performance status (ECOG PS), histology, stage and presence of autoimmune diseases; the analysis confirms that higher levels of visfatin significantly predict better survival outcomes (high vs. low HR 0.052, 95% CI: 0.005–0.586, P=0.02).
Conclusions: To our knowledge, this is the first report strongly supports the role of Visfatin as independent prognostic factor for OS in TET patients. Our findings offer a new insight that may be potentially important in the choice of the proper management for these complex patients. Further prospectives trials are needed to confirm these results.
Keywords: Prognostic factors; metabolic profiles; thymic epithelial tumors (TETs)
Acknowledgments
Funding: None.
Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://med.amegroups.com/article/view/10.21037/med-24-ab030/coif). M.O. reported speakers fee and travel accommodation from MSD, Novartis, BMS, Sanofi Regeneron, Amgen. S.D.P. reported consulting fees from Astrazeneca, Novartis, Pfizer, Roche, Daiichi Sankyo, Lilly, Clovis, Seagen, GSK, MSD, and payment or honoraria for lectures, presentations, speakers’ bureaus, manuscript writing or educational events from Astrazeneca, Novartis, Pfizer, Roche, Daiichi Sankyo, Lilly, Clovis, Seagen, GSK, MSD. S.D.P. also reported support for attending meeting/ travelling from MSD, Novartis, BMS, Sanofi Regeneron, Amgen. M.G. reported consulting fees from Lilly, Celgene, Novartis, Pfizer, and payment or honoraria for lectures, presentations, speakers’ bureaus, manuscript writing or educational events from Lilly, Celgene, Novartis, Pfizer, Istituto Gentili, Eisai Europe Ltd., Roche. M.G. also reported support for attending meetings and/or travel from Novartis, Pfizer, Roche. A.S. reported payment or honoraria for lectures, presentations, speakers’ bureaus, manuscript writing or educational events from Lilly, Gilead, MSD, Roche, Exact Sciences, Novartis, and support for attending meetings/travel from Gilead, Lilly, Istituto Gentili, MSD. R.B. reported payment or honoraria for lectures, presentations, speakers’ bureaus, manuscript writing or educational events from Roche, AstraZeneca, Novartis, Lilly, BMS, MSD, Pfizer, and participation on a Data Safety Monitoring Board or Advisory Board in Roche, AstraZeneca, Novartis, Lilly BMS, MSD, Pfizer. The other authors have no conflicts of interest to declare.
Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. The study was conducted in accordance with the Declaration of Helsinki (as revised in 2013). The study was approved by the institutional ethical committee of University of Naples Federico II (protocol #201/20), and individual consent for this retrospective analysis was waived.
Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.
doi: 10.21037/med-24-ab030
Cite this abstract as: Morra R, Di Tolla MF, Pietroluongo E, De Placido P, Ottaviano M, D’Ambrosio A, Caltavituro A, Del Deo V, Tortora M, Malfitano AM, D’Esposito V, Pellegrino S, Saponaro MR, Luciano A, De Placido S, Formisano P, Bianco R, Servetto A, Palmieri G, Giuliano M. AB030. Metabolic profiles and clinical outcome in patients with thymic epithelial tumors. Mediastinum 2024;8:AB030.
