Abstract
AB032. Clinical outcome and immunophenotype 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, Annarita Peddio1, 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, Naples, Italy; Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy. Email: rocco.mor4@gmail.com.
Background: Thymic epithelial tumors (TETs) are rare diseases, frequently associated with immune disorders. However, etiopathogenesis of immune dysregulations in TETs patients is still not totally explained. The aim of this study was to evaluate the relation between immunophenotype and overall survival (OS) in TETs patients.
Methods: From May 2019 to March 2024, consecutive TETs patients were recruited at Rare Tumors Coordinating Center of Campania Region. Serological immunophenotype from peripheral blood were evaluated, one time in each patient, at various timepoints during disease course, using the 8-color immunophenotyping kit and Treg detection kit (CD4/CD25/CD127). Log-rank test, univariate and multivariate Cox regression analyses were used for statistical analysis.
Results: A total of 45 TETs patients were included in the study: 20 (44.4%) were male and 25 were female. Thirty-five (77.8%) patients had thymoma and 10 (22.2%) thymic carcinomas. Seventeen (37.8%) patients were presenting no evidence of disease (NED), while 28 patients (66.2%) had evidence of disease (ED). Autoimmune disorders were detected in 32 TET patients (71.1%). At the time of analysis, 28 (66.2%) were alive and 17 (37.8%) patients deceased. At log-rank higher levels of leukocytes (P<0.01), lymphocytes (P=0.04), neutrophils (P=0.03), as well as lower levels of CD19+/CD3-B cells (P=0.002), and natural killer (NK) cells (P=0.04) were significantly associated with poorer OS. These results were confirmed at the univariate Cox analysis, as patients with higher levels of lymphocytes [hazard ratio (HR) =4.92; 95% confidence interval (CI): 1.86–13; P=0.01] and leukocytes (HR =2.58; 95% CI: 0.99–6.7; P=0.05), neutrophils (HR =2.86; 95% CI: 1.07–7.68 P=0.03), CD19+/CD3-B (HR =0.2; 95% CI: 0.07–0.63; P=0.01), NK cells (HR =2.85; 95% CI: 1.01–8.11; P=0.05) showed worse OS. 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 leukocytes (HR =8.99; 95% CI: 1.517–53.32; P=0.02) and lymphocytes (HR =3.569; 95% CI: 1.126–11.31; P=0.03) significantly predict poorer survival outcomes. In addition, we found that higher levels of Treg and CD4 significantly predict better OS (HR =0.156; 95% CI: 0.029–0.846; P=0.03 and HR =10.91; 95% CI: 1.545–77.05; P=0.02; respectively).
Conclusions: To our knowledge, this is the first report describing a correlation between immunophenotype and OS that may be potentially important in the choice of the proper management for TETs patients.
Keywords: Prognostic factors; immunophenotype; 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-ab032/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 or travel 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 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 or 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-ab032
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, Peddio A, Luciano A, De Placido S, Formisano P, Bianco R, Servetto A, Palmieri G, Giuliano M. AB032. Clinical outcome and immunophenotype in patients with thymic epithelial tumors. Mediastinum 2024;8:AB032.
