Scientists have identified a “molecular signature” (IFNAP) that predicts the sensitivity of liver cancer to immunotherapy drugs, a possible new pre-operative strategy that is very important for patients
There are two studies that identify for the first time which patients with liver tumors can undergo theneo-adjuvant immunotherapy (i.e. preoperative) with a high probability of success. Both represent a real breakthrough that can change the fate of those affected by this type of cancer, a significant paradigm shift, which opens up the possibility of liver transplantation even to those cases that until now could not have benefited from it due to the seriousness of the disease.
The two studies
«The scientific works that we have carried out are two, synergistic with each other – he explains Vincent Mazzaferro, director of the complex structure of hepato-gastro-pancreatic surgery of the National Cancer Institute of Milan (INT) and professor of Surgery at the University of Milan (UniMi) —. The study published in Gastroenterology identified a predictive molecular signature called IFNAP, which is made up of the combination of eleven genes. This “signature,” identified on the tumor biopsy, predicts the sensitivity of liver cancer tumor cells to the class of anti-PD1 immunotherapy drugsregardless of the origin of the tumor itself. So one was used prognostic biopsy, i.e. capable of predicting the effectiveness of drugs that could be administered. «However, we also wanted to investigate the possibility of using it liquid biopsythat is, by extracting the fragments of tumor genetic material from a simple blood sample and this was the subject of the other study, published in Gut
– underlines Mazzaferro, included in the “World’s 2% Top Scientists”, the world ranking of scientists with the highest level of scientific productivity (2% of the best in the world) -. The data has shown us that even with this method it is possible to identify 90% of liver tumors sensitive to immunotherapy treatmentswith undeniable advantages also for the patient who only undergoes a blood sample».
Radio-embolization to enhance the effect
Anti-PD1 immunotherapy drugs have been in clinical practice for years now for the treatment of melanoma, lung cancer and other solid tumors, but in the case of the liver they have variable and unpredictable efficacy. “The therapy enhances the body’s immune capacity and causes an important number of immunocompetent cells to converge on the tumor site, capable of recognizing and destroying oncogenic cells – he specifies Sherrie Bhoori, specialist in Gastroenterology and hepatology of general surgery in oncology 1 of the INT —. But we know that only 20% of patients respond to this therapy and at the moment the mechanisms that determine its sensitivity are not known. For this reason we have now entered another phase of study, i.e. the one that will allow us to identify patients who will be able to benefit from immunotherapy drugs and therefore be candidates for other more radical treatments, such as liver transplantation». However, immunotherapy is not the only path that researchers are currently following. Another recent work published on Gut
, edited by Licia Rivoltini of the Immunotherapy Unit of the INT, demonstrated the possibility of enhancing the immunological effect of anti-PD1 drugs with a pre-treatment. «Physical treatments such as radio embolization they can “prepare the ground” for the actual therapy – clarifies Mazzaferro, who coordinated the study -. Practically, stimulate the production of tumor-specific antigenscapable of activating groups of immunocompetent cells against the tumor, which will then be enhanced by immunotherapy drugs ».
The guidelines change
These studies not only broaden the range of therapeutic solutions for the treatment of liver cancercurrently the fifth most frequent cause of cancer death globally, but they can change the strategic approach the treatment of this type of cancer. “It will still take further research to obtain increasingly personalized therapies – concludes Bhoori -, but the decision of the European Society for Organ Transplantation (ESOT) is significant: having examined the results of scientific work, it was approved the inclusion of neo-adjuvant immunotherapy in the forthcoming European guidelines. This therapeutic approach therefore becomes one of the possible strategies to be adopted in selected cases, in particular when the so-called “molecular signature” is present”.
December 5, 2022 (change December 5, 2022 | 5:39 pm)
© Time.News