RESUMO
Colorectal cancer (CRC) is one of the most frequently encountered neoplasms and has a high rate of morbidity and mortality. Recent findings showing that tumor immune evasion is an important mechanism underlying propagation of a cancer have changed the landscape of medical oncology through identification of ProgrammedDeath receptor 1 and its ligand (PD1 and PDL1) as novel targets for oncological immune therapies. PD1 is primarily expressed on peritumoral lymphocytes and when activated, it suppresses its immune functions. Conversely, PDL1 is primarily expressed on the tumor infiltrating front with the purpose of deregulating physiological cytotoxic immune responses. Numerous studies have linked PDL1 overexpression to specific adverse clinicopathological features, such as poor differentiation, lymphovascular invasion and worse overall survival in CRC patients. Nevertheless, there is no concrete evidence showing which patients may exhibit the maximal beneficial effects of PD1/PDL1 blockade therapy, and how these novel molecular targets may be optimally integrated into therapeutic regimens for management of CRC patients with resectable and generalized disease.
Assuntos
Antígeno B7-H1/antagonistas & inibidores , Neoplasias Colorretais/tratamento farmacológico , Inibidores de Checkpoint Imunológico/uso terapêutico , Evasão Tumoral/efeitos dos fármacos , Microambiente Tumoral/efeitos dos fármacos , Antígeno B7-H1/metabolismo , Tomada de Decisão Clínica , Neoplasias Colorretais/imunologia , Neoplasias Colorretais/patologia , Humanos , Inibidores de Checkpoint Imunológico/farmacologia , Seleção de Pacientes , Receptor de Morte Celular Programada 1/antagonistas & inibidores , Receptor de Morte Celular Programada 1/metabolismo , Transdução de Sinais/efeitos dos fármacos , Transdução de Sinais/imunologia , Microambiente Tumoral/imunologiaRESUMO
BACKGROUND: For Greece, no data regarding the incidence of cutaneous melanoma (CM) have been reported. In this report, we present epidemiologic data for CM on Crete, an island in southern Greece, during the years 1999-2002. We attempt a comparison with corresponding data reported for the Italian population. METHODS: One hundred and two CM patients of Cretan origin with primary CM first diagnosed between the years 1999-2002 were interviewed and underwent complete skin examination by the same two experienced dermatologists. Crude and/or age-standardized incidence rates were calculated for Crete as a whole, as well as for each one of the four prefectures of the island. RESULTS: The age-standardized incidence rate according to the Greek population was 4.6 per 100,000 person-years for men and 4.7 per 100,000 person-years for women. The crude incidence rates did not differ significantly between the four prefectures. Significant differences between Cretan and Italian CM patients were found in terms of gender, age at diagnosis, anatomic site and histogenetic type of CM, hair color, skin reaction to sun exposure, history of sunburn before the age of 15 years, presence of solar lentigines, and total common nevus count. CONCLUSIONS: The incidence of CM on Crete is higher than that estimated for the whole of Greece and comparable with the incidence reported for other southern European countries.