Immunological signatures and clinical outcomes in patients with thymic epithelial tumors and Good syndrome.

Abstract

e20140 Background: Thymic epithelial tumors (TETs) are rare neoplasms often associated with paraneoplastic syndromes, which manifest as either autoimmune diseases (AD) or immunodeficiency-related conditions, such as Good Syndrome (GS). Prognostic factors for TETs are primarily defined by the TNM staging system and the Masaoka-Koga classification. However, to date, no studies have explored the relationship between immunophenotype, cytokine and chemokine levels, and clinical outcomes in patients (pts) with TETs. This study aims to assess differences in immunological signature, as well as clinical outcome in pts with TETs and GS with or without autoimmune disorders (AD). Methods: From May 2019 to March 2024, consecutive TETs pts were recruited at Rare Tumors Coordinating Center of Campania Region. Peripheral blood serological immunophenotypes were evaluated, one time in each pts, at various timepoints during the disease course, using an 8-color immunophenotyping kit, a Treg detection kit (CD4/CD25/CD127), and pre-formed kits by Bioplex multiplex. D’Agostino-Pearson normality test was used to evaluate whether the continuous data were normally distributed, and a two-tailed t-test for independent samples was used. Overall survival (OS) analysis was performed generating Kaplan-Meier curves and Cox Univariate models for the considered categorical stratifications. p-values , 0.05 were considered statistically significant. Results: Among the 36 pts enrolled, 20 (55.6%) were female; 30 (83.3%) had thymoma and 6 (16.7%) thymic carcinomas. Autoimmune diseases were found in 20 (55.6%) patients all of whom had thymoma. At the time of analysis, 22 (61.1%) were alive and 14 (38.9%) patients deceased. 11 (30.6%) patients had no evidence of disease (NED) by imaging. The analysis of leucocytes did not show statistically significant differences in TET pts with AD compared to TET pts without AD. However, a trend toward higher CD4+ T cells was observed in TETs pts with AD (p= 0.095). Conversely, TET pts with AD showed significantly higher circulating levels of IL-8 (p= 0.047), with respect to TET pts without AD. Furthermore, significantly higher serum levels of circulating inflammatory markers MCP-1 and MIP-1β (p= 0.029 and p=0.038 respectively) in pts with evidence of disease, as compared to NED pts. At survival analysis, no significant association with a worse outcome was found for neither AD or ED. Conclusions: Our preliminary data provide valuable insights into the immunological profiles and clinical outcomes of TETs and GS pts, with or without AD. Significant differences were observed in the immunological profiles and clinical outcomes between these groups. Further prospective trials are needed to better understand the immunophenotypic alterations in TETs, which may offer new perspectives for improving the clinical management of this complex disease.