Cancer Immunoprevention and Public Health

Abstract

The power of cancer immune surveillance has been documented beyond doubt, and the successful exploitation of immune response to cancer has started a new era in the war against cancer. Cancer biologists have recognized immunoevasion as an emerging hallmark in addition to the six hallmarks of cancer. Besides the natural connection between the immune system and cancer development, most established environmental risk factors are now known to interfere with immune surveillance mechanisms. Genetic variations regulating immunity may also modulate cancer susceptibility, but evidence for this is currently limited. Molecular cross talk linking “immune” and “genomic” surveillance pathways has been characterized. It appears that immune mechanisms may contribute to the effects of common cancer risk factors. We provide an updated overview of evidence for cancer immune surveillance, cancer risk factors interfering with it, and interventions to enhance cancer immune surveillance as tools to complement ongoing vaccine development efforts for cancer immunoprevention. Although there is a lot of support for cancer immunoprevention with simple lifestyle modifications from observational studies, there is an urgent need for clinical trials to establish the effectiveness of this approach for public health benefits.

Cancer immunoprevention: from mice to early clinical trials

“…Finally, most lifestyles (e.g. diet, physical activity) and chemopreventive treatments conducive to reductions in cancer risk also seem to have beneficial effects on the immune system [ 50 ], leading to the prediction that complex preventive regimes combining behavioral, chemopreventive and immunopreventive components could have additive or synergistic effects.…”

PTEN-opathies: from biological insights to evidence-based precision medicine

“…For example, germline PTEN mutations such as C-terminal deletions that result in genomic instability could prime tissues that are particularly sensitive to DNA damage for progression to malignancy (117). Finally, the immune system has been recognized as a major determinant of cancer development (118)(119)(120). PTEN loss promotes resistance to tumor immune cell infiltration through the production of inhibitory cytokines, hence resulting in immune escape (121).…”

Multifaceted Effects of Extracellular Adenosine Triphosphate and Adenosine in the Tumor–Host Interaction and Therapeutic Perspectives

“…In the elimination and equilibrium phase innate and adaptive immune system—mainly NK and T cells—mount an effective immune response against the highly immunogenic tumors, and allow the less immunogenic ones escape ( 8 – 16 ). This immunologic pressure selects and favors tumor variants resistant to the immune system to proliferate (immunoevasion) ( 9 , 17 ). During this process, both cancer and inflammatory cells release several soluble factors such as cytokines, chemokines, growth factors, matrix-degrading enzymes, and nucleotides that facilitate tumor immune escape and allow tumor growth, angiogenesis, invasion, and metastasis ( 18 – 22 ).…”