PDL-1 nella prognosi e terapia del carcinoma tiroideo differenziato ad andamento aggressivo

Introduction: differentiated thyroid cancer (DTC) is the most common neoplasm of the endocrine system. 10% of DTC have aggressive behaviour with poor prognosis. PD-1 (programmed death 1) is physiologically found on the surface of macrophages and T cells. Its ligand, PD-L1, is expressed on the membrane of various cells, including cancer cells. The interaction between PD-1 and its ligands results in immune tolerance by suppressing the cytotoxic immune response of T cells. PD-L1 is aberrantly expressed on tumour cells in response to persistent stimulation of oncogenic signalling pathways. We evaluate the presence of main mutations and immunological targets within our population of DTC.PD-L1 could be considered a potential target for immunotherapy in the management of progressive and iodine refractory DTCs. Materials and methods: molecular investigations have been done on 14 subjects with aggressive DTC Results: 43% of patients have aberrant PD-L1 expression. Patients with this mutation have different histological diagnosis: 33% papillary thyroid cancer (PTC), 33% follicular thyroid carcinoma (FTC), 33% anaplastic thyroid carcinoma (ATC). All patients developed metastases during follow up. Conclusions: The positivity of PD-L1 on our population poses new therapeutic possibilities (immunotherapy) for patients with a poor prognosis