Immunology of Gynecologic Neoplasms: Analysis of the Prognostic Significance of the Immune Status

Abstract

Gynecologic Oncology has changed in the last few decades. An increasing proportion of patients is benefiting from long term survival although patients diagnosed with advanced disease suffer from a poor prognosis. Unfortunately, several recent studies are confirming that changing the combinations of "traditional" cytotoxic drugs is unlikely to obtain a real breakthrough in survival rates. Furthermore, there is discouraging data regarding consolidation therapies. It is, therefore, necessary to identify new target therapies with a minimal impact on quality of life. It is likely that new breakthroughs are only going to be achieved when changes in therapies are tailored to the entire natural history of the disease and on specific patient characteristic's. Since the discovery that tumor infiltrating lymphocytes represent an independent prognostic factor in ovarian cancer patients, several researchers have dedicated their attention to cancer immune response in order to identify prognostic factors and immunological targets. Analyses on immunophenotype at diagnosis and throughout the entire course of treatment are currently ongoing and are giving the new diagnostic, prognostic and therapeutic tools to the physicians. Furthermore new antigens and new vaccination strategies are being investigated. Encouraging data on selected patient populations have been observed recently. The objective of the present review is to define the immunology of women affected by gynecological malignancies and describe new immunological targets for prognostic and therapeutic use.

Triple negative breast cancer in Moroccan women: clinicopathological and therapeutic study at the National Institute of Oncology

“…The systemic effect of neoadjuvant chemotherapy on the immune system deserves to be accurately investigated. Several researchers have dedicated their attention to cancer immune response in order to identify prognostic factors and immunological targets [29]. In a recent study, Denkert and al reported that it is possible to identify a subgroup of breast carcinomas that is characterized by a lymphocytic infiltrate In the tumor tissue and a particularly strong response to chemotherapy [30,31].…”

Status of cellular immunity lacks prognostic significance in vulvar squamous carcinoma

“…Although our results suggest that important players in the adaptive immune system do not seem to have an influence on survival, these results need to be confirmed (or rejected) by future research. Attempts have been made to identify tumor associated antigens as possible targets in vulvar carcinoma [38]. Hopefully, this will lead to more research concerning targeted therapy in an approach to improve prognosis of vulvar carcinoma patients.…”

A retrospective analysis of the clinicopathologic characteristics of uterine cellular leiomyomas in China

“…Many tumor-associated antigens, such as squamous cell carcinoma antigen and cancer antigen 125, have been used not only in the differential diagnosis of gynecologic tumors but also as prognostic tools, to assess therapeutic response and detect recurrence [10]. Immunohistochemistry offers some assistance in differentiating between CL and malignant disease.…”