Abstract
BACKGROUND: In the last decade, the tumor microenvironment has been considered as one of the key factors determining the prognosis and nature of the necessary therapeutic interventions. Currently, there is only one validated and approved predictive model that includes microenvironment components. Several classifications of the tumor microenvironment based on the nature of the predominant cellular subpopulations have been proposed.
AIM: The aim of the study was to assess the prognostic significance of the immunological components of blood and the microenvironment, as well as to create prognostic models for oncourological tumors.
MATERIALS AND METHODS: The study used clinical data from 115 patients with kidney, bladder and prostate cancer. Immunological parameters in the tumor and blood microenvironment were evaluated in all patients. The end point of observation was the median time to progression. The influence of various parameters on long-term treatment outcomes was evaluated using the log rank and the Gehan–Wilcoxon criteria. A model of proportional hazard was used to identify the combined effect of several parameters on lifetime indicators.
RESULTS: The developed prognostic models for all studied groups include spontaneous production of three cytokines: IL-6, IL-8 and IL-10. The prognostic models for renal cell carcinoma and prostate cancer also included immunosuppressive components: MDSC and Treg. The median time to progression in patients with invasive urothelial cancer is influenced by components that contribute to tumor destruction: TNK cells and IFN-γ. In all the studied groups of patients (renal cell carcinoma, muscle-invasive urothelial cancer, prostate cancer), the median time to progression significantly differs in subgroups with different numbers of immunological risk factors for tumor microenvironment.
CONCLUSIONS: The developed prognostic models are based on modern achievements of oncoimmunology and after conducting multicenter validation studies, they can be recommended for clinical use.