The Tumor/Immune Interface: Clinical Evidence of Cancer Immunosurveillance, Immunoediting and Immunosubversion

Problem statement: The interactions of a malignant tumor with the patient’s immune system are dynamic, multiple and bi-directional. Approach: This article reviews the clinical evidence of the interaction of cancer with immunity with emphasis on recent developments highlighting some of the mechanisms of tumor-mediated regulation of immunity. Results: Most of the time, the immune response to a malignancy acts to prevent/contain tumor growth. Immune responses to tumor-associated antigens are frequently detected in the setting of tumor development. Furthermore, individuals with various forms of immune deficiency are at increased risk for the development of malignancies compared with the general population. However, immune responses to tumors rarely lead to eradication of clinically detectable established cancer, and many cancers are thought to become more aggressive in the setting of tumor-targeted inflammation. Individuals with cancer typically exhibit aberrancies in immune function, both within the tumor microenvironment as well as throughout the body. Conclusion: Tumors have been demonstrated to produce cell surface molecules, cytokines and growth factors that disrupt normal immunity, supporting the hypothesis that tumors dysregulate the immune system in favor of their progression.