Tumor Immune Microenvironment in Gynecologic Cancers

Abstract

Gynecologic cancers have varying response rates to immunotherapy due to the heterogeneity of each cancer’s molecular biology and features of the tumor immune microenvironment (TIME). This article reviews key features of the TIME and its role in the pathophysiology and treatment of ovarian, endometrial, cervical, vulvar, and vaginal cancer. Knowledge of the role of the TIME in gynecologic cancers has been rapidly developing with a large body of preclinical studies demonstrating an intricate yet dichotomous role that the immune system plays in either supporting the growth of cancer or opposing it and facilitating effective treatment. Many targets and therapeutics have been identified including cytokines, antibodies, small molecules, vaccines, adoptive cell therapy, and bacterial-based therapies but most efforts in gynecologic cancers to utilize them have not been effective. However, with the development of immune checkpoint inhibitors, we have started to see the rapid and successful employment of therapeutics in cervical and endometrial cancer. There remain many challenges in utilizing the TIME, particularly in ovarian cancer, and further studies are needed to identify and validate efficacious therapeutics.

The effect of telomeres in cervical cancer

“…As a chemokine, CCL20 helps to prevent infection, hemostasis, cell proliferation, and remodeling. It also attracts antigens in the form of delivery cells, such as Langerhans cells, to the virus-infected area 34 . Immunoin ltrating data showed that telomere core genes associated with cervical cancer were associated with Mast cells resting, Dendritic cells resting, T cells regulatory (Tregs), T cells CD8, Mast cells activated, Macrophages, Neutrophils, B cells memory, T cells gamma delta, Monocytes and other immune cells were signi cantly correlated.…”