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Review
. 2019 Feb;39(1):2-8.
doi: 10.14639/0392-100X-2481.

Knowing the tumour microenvironment to optimise immunotherapy

M C Merlano  1   2 , A Abbona  2 , N Denaro  1 , O Garrone  1   3
Affiliations
Review

Knowing the tumour microenvironment to optimise immunotherapy

M C Merlano et al. Acta Otorhinolaryngol Ital. 2019 Feb.

Abstract

Conoscere il microambiente tumorale per ottimizzare l’immunoterapia.

Riassunto: Una immunoterapia efficace richiede una profonda conoscenza del microambiente tumorale. Infatti l’interazione fra il sistema immune, il tumore e il trattamento è condizionata dalla composizione del microambiente. Inoltre si deve tenere in considerazione che l’equilibrio del microambiente è altamente dinamico e cambia rapidamente in funzione di molti fattori, come il livello di infiammazione, l’ipossia, il volume tumorale, tutti fattori che cambiano nel tempo, e gli effetti dei trattamenti. Tutti questi fattori interagiscono gli uni con gli altri e con condizioni correlate al tumore, (il carico mutazionale o la percentuale di mutazioni clonali o subclonali) o all’ospite (stili di vita, dieta, obesità, età). Tutti questi fattori, così come la loro interazione, influiscono sulla risposta all’immunoterapia. L’obiettivo di questa breve review è di riassumere alcuni dei principali aspetti che interferiscono con l’omeostasi del microambiente tumorale e come la sua struttura può guidare la scelta terapeutica.

Keywords: Immunotherapy; Treatment targets; Tumour microenvironment.

Plain language summary

Effective immunotherapy requires thorough knowledge of the tumour microenvironment. Indeed, the interplay among the immune system, the tumour and treatment is conditioned by the composition of the tumour microenvironment. In addition, it must be taken into account that homeostasis of the tumour microenvironment is highly dynamic and changes rapidly in function of many factors, such as inflammation, hypoxia, tumour volume, all of which change over time, and the effect of treatments. All these elements interact with each other and with conditions related to the tumour (i.e. mutational load, rate of clonal and subclonal mutations) and to host (life style, diet, obesity, age). All these factors as well as their interplay, affect the response to immunotherapy. The target of this short review is to summarise some of the major aspects that impact the homeostasis of the tumour microenvironment and how its structure can drive treatment choice.

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