Circulating regulatory T-cells and the clinical outcome of VEGF-targeted treatment of metastatic colorectal cancer patients: focused on KRAS status and primary tumour sidedness

      Background: Regulatory T-cells (Tregs) play an important role in escape of tumour cells from immune surveillance and their presence in the tumour microenvironment and presumably their increase in circulation reflects the level of tumour immunosuppression. The anti-cancer effect of anti-VEGF bevacizumab is conferred not only by its anti-angiogenic but also by its immunomodulatory effect. We have observed that primary tumour sidedness is an important predictor of the clinical outcome of the 1st anti-VEGF therapy of metastatic CRC where patients with right-sided tumours have poor prognosis irrespective of KRAS status and patients with left-sided colon carcinoma benefited from anti-VEGF therapy specifically those with wt KRAS (1). Our goal was to investigate whether circulating Treg level in mCRC patients i/ differs according to primary tumour sidedness, ii/ is related to tumour KRAS status, iii/ predicts anti-VEGF treatment outcome.
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