Clinical implications of immune cell infiltration in vulvar intraepithelial neoplasia
- E.M.G. van Esch
- 1 december 2015
2311 GJ Leiden
Promotor(s): Prof.dr. S.H. van der Burg, prof.dr. J.B.M.Z. Trimbos
Co-promotor(s): Dr. M.I.E. van Poelgeest
Vulvar intraepithelial neoplasia is a chronic premalignant skin disease caused by a persistent human papillomavirus infection for which conventional surgical therapies are only partially successful as in 40% of all treated patients the disease returns and it may progress to cancer. The incidence of uVIN is increasing, mainly in young women and its treatment is associated with sexual and psychological problems.
Immunotherapy is a new form of therapy that stimulates the body’s own immune system to resolve infections and cancers. uVIN is the first HPV-induced disease successfully treated by immunotherapy, stressing the capacity of the immune system to deal with disease. Despite these considerable successes of immunotherapy, there is a high need to identify parameters of the immune system which allow to select the patients most likely to respond to treatment as well as to understand why others do not respond. The studies in this thesis resulted in the identification of a number of immune parameters that positively or negatively predict the course of disease. These immune parameters may be of great use as new prognostic biomarkers to identify patients most likely to respond to current successful immune therapeutics or identify patients at risk to the recurrent or progressive course of the disease. Moreover the knowledge of the immune profile may help to understand the non-responsiveness to immunotherapy of some patients which can be used to optimize these therapies and to foster individualised (immune) therapies.
Inès van Arkel, Adviseur wetenschapscommunicatie
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