Immunotherapy in endometrial cancer: rationale, practice and perspectives

Abstract

Tumor immunotherapy has attracted more and more attention nowadays, and multiple clinical trials have confirmed its effect in a variety of solid tumors. Immune checkpoint inhibitors (ICIs), cancer vaccines, adoptive cell transfer (ACT), and lymphocyte-promoting cytokines are the main immunotherapy methods. Endometrial cancer (EC) is one of the most frequent tumors in women and the prognosis of recurrent or metastatic EC is poor. Since molecular classification has been applied to EC, immunotherapy for different EC subtypes (especially POLE and MSI-H) has gradually attracted attention. In this review, we focus on the expression and molecular basis of the main biomarkers in the immunotherapy of EC firstly, as well as their clinical application significance and limitations. Blocking tumor immune checkpoints is one of the most effective strategies for cancer treatment in recent years, and has now become the focus in the field of tumor research and treatment. We summarized clinical date of planned and ongoing clinical trials and introduced other common immunotherapy methods in EC, such as cancer vaccine and ACT. Hormone aberrations, metabolic syndrome (MetS) and p53 mutant and that affect the immunotherapy of endometrial cancer will also be discussed in this review.

Integrated Bioinformatics Analysis of Serine Racemase as an Independent Prognostic Biomarker in Endometrial Cancer

“…Immune cells and cytokines can be found in large numbers in EC tissues, stimulating an endogenous antitumor immune response ( Cao et al, 2021 ). In our study, SRR expression was significantly and positively correlated with the levels of CD8 + cytotoxic T cells and dendritic cell infiltration.…”

“…We then looked at using SRR as a marker for chemotherapy and immune therapy in patients with UCEC to see if it could be used in clinical treatment. Immunotherapy is more likely to benefit EC than other types of gynecological malignancies ( Cao et al, 2021 ). TMB and MSI were predictive markers for immune checkpoint inhibitors.…”

Endometrial Cancer Stem Cells: Where Do We Stand and Where Should We Go?

“…Immunotherapies can be categorized in two ways: active, where an immune response is actively triggered by transferred cells or vaccines, and passive with transferred antibodies such as immune checkpoint inhibitors. Regarding endometrial cancer, peptide, dendritic cell and nucleic acid based vaccines are currently being trialed amongst others, yet still need to be clinically approved [ 103 ]. Passive immunotherapies include immune checkpoint blockage by targeting programmed death ligand 1 (PD-L1) or cytotoxic T-lymphocyte-associated protein 4 (CTL4) as well as bispecific T-cell engager (BiTE) antibodies [ 104 ].…”

Microsatellite instability and chemosensitivity in solid tumours

“…However, the prognostic value of TMB, PD-L1 expression, tumour-infiltrating lymphocytes (TILs) and Janus kinase 1 (JAK1) and β2-microglobulin (B2M) mutations in MSI EC patients needs to be clarified. 108 – 111 …”