Abstract:
Immunotherapy has emerged as promising treatment in sarcomas, but the high variability in terms of histology, clinical behavior and response to treatments determines a particular challenge for its role in these neoplasms. Tumor immune microenvironment (TiME) of sarcomas reflects the heterogeneity of these tumors originating from mesenchymal cells and encompassing more than 100 histologies. Advances in the understanding of the complexity of TiME have led to an improvement of the immunotherapeutic responsiveness in sarcomas, that at first showed disappointing results. The proposed immune-classification of sarcomas based on the interaction between immune cell populations and tumor cells showed to have a prognostic and potential predictive role for immunotherapies. Several studies have explored the clinical impact of immune therapies in the management of these histotypes leading to controversial results. The presence of Tumor Infiltrating Lymphocytes (TIL) seems to correlate with an improvement in the survival of patients and with a higher responsiveness to immunotherapy. In this context, it is important to consider that also immune-related genes (IRGs) have been demonstrated to have a key role in tumorigenesis and in the building of tumor immune microenvironment. The IRGs landscape in soft tissue and bone sarcomas is characterized by the connection between several tumor-related genes that can assume a potential prognostic and predictive therapeutic role. In this paper, we reviewed the state of art of the principal immune strategies in the management of sarcomas including their clinical and translational relevance.
摘要:
免疫疗法已成为肉瘤的有希望的治疗方法,但是组织学上的高度变异性,临床行为和对治疗的反应决定了其在这些肿瘤中的作用的特殊挑战。肉瘤的肿瘤免疫微环境(TiME)反映了这些源自间充质细胞的肿瘤的异质性,涵盖了100多个组织学。对TiME复杂性的理解的进步导致了肉瘤中免疫治疗反应的改善,起初显示出令人失望的结果。基于免疫细胞群和肿瘤细胞之间的相互作用提出的肉瘤免疫分类表明对免疫疗法具有预后和潜在的预测作用。一些研究已经探索了免疫疗法在这些组织型的管理中的临床影响,导致有争议的结果。肿瘤浸润淋巴细胞(TIL)的存在似乎与患者生存率的提高以及对免疫疗法的更高反应性相关。在这种情况下,重要的是要考虑到免疫相关基因(IRGs)也已被证明在肿瘤发生和肿瘤免疫微环境的建立中具有关键作用。软组织和骨肉瘤中的IRGs景观的特征在于几个肿瘤相关基因之间的联系,这些基因可以承担潜在的预后和预测性治疗作用。在本文中,我们回顾了治疗肉瘤的主要免疫策略的最新技术,包括它们的临床和转化相关性。