The role of tumour microenvironment in the biological behaviour and outcomes of pituitary adenomas: new immune-related biomarkers and therapeutical targets

The proposed research aims to explore further the role of the tumour microenvironment (TME) in pituitary adenomas (PAs), a field with little data in contrast to other neoplasia. Our study will provide novel and significant insights into the PA pathology and biology, particularly whether different PA-derived chemokines are important mediators or drivers for some of the underlying tumorigenic mechanisms and poorer clinical outcomes in PA patients. With this study we can identify valuable markers for aggressive disease which can be translated into clinical practice, for example by incorporating such markers in the standard pituitary pathological reports or aiding the patients risk stratification, and thus in defining their management approach. We also may identify novel pharmacological targets potentially useful for the management of patients with aggressive or refractory PAs. In fact, anti-cancer drugs targeting chemokines have been studied to treat advanced solid tumours (e.g. human antibody against CCL2 or HuMax-IL8, an anti-IL-8 monoclonal antibody). Moreover, we will also aim to further characterise the serum cytokine/chemokine profile of patients with PAs in order to identify further biomarkers eventually useful for the management and predicting the prognosis of patients with PAs.