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Dynamic crosstalk within the tumor microenvironment of uterine cervical carcinoma: baseline network, iatrogenic
Rosalba De Nola1, Vera Loizzi2, Ettore Cicinelli2
1Department of Tissues and Organs Transplantation and Cellular Therapies, D.E.O.T., University of Bari "Aldo Moro", Piazza G. Cesare, 11-Policlinico, 70124, Bari, Italy; Department of Biomedical and Human Oncological Science, Division of Obstetrics and Gynecology, University of Bari "Aldo Moro", Piazza G. Cesare, 11-Policlinico, 70124, Bari, Italy; Gynecologic Oncology Unit, IRCCS, Istituto Tumori Giovanni Paolo II, 70142, Bari, Italy.
Abstract:
Uterine cervical cancer is the fourth most frequent gynecological tumor worldwide. The tumor microenvironment of cervical cancer is the result of persistent high-risk human papillomavirus infection together with stromal activation of estrogen receptor alpha and the pro-angiogenic and pro-inflammatory activity of immune cells, mainly T-helper 17 cells and tumor-associated macrophages. Therapeutic management (e.g., immunotherapy, especially in advanced cases) may be influenced by the translational implications of tumoral stroma crosstalk and an abundance of tumor-infiltrating lymphocytes within the tumor microenvironment. The prognosis of cervical cancer is inversely correlated with microvessel density, making anti-angiogenic strategies with agents such as bevacizumab crucial for improving both progression-free survival and overall survival in patients with advanced and recurrent tumors.
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