PROGETTO Serpentine

Quantifying systemic immunosuppression to personalize cancer therapy.

In this project FRRB finances Partner number 5: ASST Papa Giovanni XXIII, Bergamo. The Principal Investigator responsible of the project is Dr. Mario Mandalà.

 Pathology of interest:

 Cancer – systemic immunosuppression

 Area of research:


 Start date:

 to be defined

 End date:



 € 225.674,00

 Project partners:

  • Fondazione IRCCS Istituto Nazionale dei Tumori di Milano – INT
  • German Cancer Research Center (DKFZ)
  • Institut du Cancer de Montpellier, ICM
  • Oslo University Hospital (OUH)
  • ASST Papa Giovanni XXIII – Bergamo
  • Tanta University


Most cancer therapies are reported to rely on the contribution of host immunity for exerting clinical benefit.

Efficacy is usually accompanied by the increase of T cell tumor infiltrate, while resistance is featured by the accrual of myeloid immunosuppressive cells (MDSC).

Particularly, the frequency of MDSC in blood has been associated by many groups, including ours, to poor prognosis and resistance to treatment in several malignancies. Nonetheless, no effort to translate this key concept into clinical practice for stratifying cancer patients and possibly increasing their curability by personalizing treatment strategy, has been performed so far.

The Serpentine Project is committed to achieve this goal in a concerted fashion by exploiting the clinical and scientific expertise of the Consortium members, to provide a new, strong, affordable and easy prognostic/predictive biomarker based on quantifying systemic immunosuppression. A prospective multicentric study enrolling patients with representative neoplasms treated with standard therapy, will be performed and blood samples collected at baseline and during treatment for MDSC-related analyses.

A Myeloid Index Score (MIS), obtained by 4-color cytometry recently developed within the Consortium, will be assessed and recorded in a shared in-cloud database together with clinical data and additional information collected throughout the study. Baseline MIS will be correlated with PFS and OS, to define a risk of therapeutic resistance.

In parallel, blood MDSC and plasma will be studied in depth by genomic, and transcriptional profiling to implement MIS and identify novel MDSC-targeting strategies to be tested on an MDSC-in vitro model platform. The Serpentine is designed to provide the first tool for assessing systemic myeloidmediated immune suppression in cancer patients and discovering new drug modulating strategies, to help tailoring treatments and improving cancer curability in a real life setting.


EraPerMed results of the JTC2019 available for download here: