Gética 2020

48 VI FORO DE Inmunología Traslacional e INMUNOTERAPIA DEL CÁNCER Fundamentos y objetivos: El cáncer es un pro- blema cada vez más relevante en el paciente ancia- no. Las comorbilidades de estos pacientes limitan el uso de la quimioterapia (QT) debido a su potencial toxicidad. Aunque la evidencia sobre la eficacia de los inhibidores de puntos de control (ICI) es limi- tada en ancianos, éstos aparentemente son mejor tolerados en comparación con la QT. A pesar de ello, estos pacientes pueden ver su calidad de vida mermada significativamente debido a los síntomas locales producidos por la enfermedad. En este con- texto, la radioterapia estereotáctica ablativa (SABR) es efectiva para el control sintomático local y, ade- más, puede potenciar la respuesta inmune cuando se combina con ICI. Reportamos el caso de una pa- ciente anciana que presentó un efecto abscopal tras CP06. Radioinmunoterapia en una paciente anciana con melanoma metastásico: beneficios de una combinación emergente Zafra Martín, Juan 1 ; Castilla Martínez, Juan 1 ; Chicas-Sett, Rodolfo 1 ; Morales Orúe, Ignacio 2 ; Lloret, Marta 1 1 Hospital Universitario de Gran Canaria Doctor Negrín. Las Palmas de Gran Canaria. 2 Hospital Punta de Europa. Algeciras, Cádiz recibir concomitancia con ICI y SABR exclusivamen- te sobre un volumen parcial. Paciente y métodos: Mujer de 87 años con melanoma metastásico que presenta múltiples implantes metastásicos a lo largo del miembro in- ferior derecho. Inicialmente había recibido IL-2 y temozolamida. Tras progresión confirmada por PET, fue remitida para valoración de tratamiento local sintomático. A la exploración, la paciente presen- taba dolor, lindefema avanzado e importante limi- tación funcional por una masa bulky iliaca-inguinal derecha. Aunque partía de un índice de Barthel de 100, con la aparición del linfedema se había vuelto dependiente para las actividades de la vida diaria. Dada la buena función previa y la ausencia de co- morbilidades, se decidió suspender el tratamien- like irritation or infection. With the aim of identifying immune parameters that could contribute to patient classification, we have performed a longitudinal study in urine recruited from bladder cancer patients treat- ed with BCG. As well as certain chemokines that we have recently reported (Ashiru et al, Cancers 2019), we have also characterized immune cells released in urine 7 days after recurrent BCG instillations. Patients and methods: Non-muscle invasive bladder cancer patients treated with BCG at either Hospital Infanta Sofía or Hospital Universitario La Paz (Madrid, Spain), n = 14; mean age 72 years) were recruited after informed consent and permis- sion by the ethical research committee of the hospi- tal. Cells were isolated from urine samples collected 3 to 7 days after the patients had received instilla- tions at different weeks. Results: The number and shape of urinary cells var- ied between donors, but consistently hematopoiet- ic-like, as well as flat, fibroblast-like cells could be iden- tified in these preparations, as observed by light and electron microscopy. Flow cytometry, mass cytometry and qPCR allowed the phenotyping of several leuko- cyte populations. As previously reported, granulocytes were very abundant, however, their detailed pheno- type revealed that these cells could be consistent with either activation or suppression in different patients. Patients with irritation and infection had a strong pres- ence of a particular granulocyte phenotype, reminis- cent of tumour associated neutrophils, easily detect- able by flow cytometry. Conclusions: This first detailed analysis of cells in urine, using a sophisticated laboratory-based meth- odology, has also been optimised for translation to standard techniques employed in every hospital for blood analysis. Thus, it provides the proof-of-con- cept for the follow-up of bladder cancer using urine cells and for early identification of patients with an excessive, detrimentally strong or insufficient response to BCG therapy. These data are being ex- tended in studies of larger patient cohorts to con- firm the data presented here. Financiering: Madrid Regional Government “IMMU- NOTHERCAN” [S2017/BMD-3733-2 (LMP, MVG)]; the Spanish Ministry of Science and Innovation [RTI2018- 093569-B-I00, RTC-2017-6379-1 (MCIU/AEI/FEDER, EU) (MVG)]. MVG was a Visiting Associate Professor in the laboratory of Prof CA Blish at the University of Stanford funded by a “Salvador de Madariaga” grant, Spanish Ministry of Education (MECD). Recommended references 1. Ashiru O, Esteso G, García-Cuesta EM, et al. BCG Ther- apy of Bladder Cancer Stimulates a Prolonged Release of the Chemoattractant CXCL10 (IP10) in Patient Urine. Cancers 2019;11(7). pii: E940.