Goal The goal and purpose of this study is to investigate the clinical implications and
functional roles of immune checkpoint pathways in CNSL.
There are two specific aims:
1. The adoption of protein expression of immune checkpoint pathways (CTLA-4, PD-L1, PD-L2,
CD47) as a prognostic factor in patients with PCNSL. To fulfill this aim, the protein
expression of CTLA-4, PD-L1, PD-L2, and CD47 in the neurosurgical resection specimens of
patients with PCNSL will be evaluated by immunohistochemistry (IHC) techniques. The
results will be correlated with clinical features and outcome of the patients with CNSL.
Once parameters for these tissues are established it will be possible to speculate about
the tumor grade, survival and response to treatment of these patients.
2. The feasibility of adopting CSF CTLA-4, PD-L1, PD-L2, and sCD47 as useful diagnostic and
prognostic biomarkers in patients with CNSL. To fulfill this aim, the concentrations of
CSF CTLA-4, PD-L1, PD-L2 and sCD47 will be evaluated at the timings of initial diagnosis
and after each cycle of systemic chemotherapy by enzyme-linked immunosorbent assays
(ELISAs). The concentrations of these CSF molecules at initial diagnosis will be
correlated with the prognosis of patients with CNSL. Besides, the investigators will
compare the serial follow-up concentrations of these markers after each cycle of
systemic chemotherapy to find out whether the presence of decreased concentrations will
response to therapy.
This may help to discovery new diagnostic, prognostic and potential therapeutic strategies
for patients with CNSL.