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Updated: Aug 23, 2025

Advances in Human Induced Pluripotent Stem Cell-Derived Chimeric Antigen Receptor-Expressing Natural Killer Cells
Published on: February 14, 2025
NK cells and solid tumors: therapeutic potential and persisting obstacles
Le Tong1, Carlos Jiménez-Cortegana2,3, Apple H M Tay1,4
1Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden.
Abstract:
Natural killer (NK) cells, which are innate lymphocytes endowed with potent cytotoxic activity, have recently attracted attention as potential anticancer therapeutics. While NK cells mediate encouraging responses in patients with leukemia, the therapeutic effects of NK cell infusion in patients with solid tumors are limited. Preclinical and clinical data suggest that the efficacy of NK cell infusion against solid malignancies is hampered by several factors including inadequate tumor infiltration and persistence/activation in the tumor microenvironment (TME). A number of metabolic features of the TME including hypoxia as well as elevated levels of adenosine, reactive oxygen species, and prostaglandins negatively affect NK cell activity. Moreover, cancer-associated fibroblasts, tumor-associated macrophages, myeloid-derived suppressor cells, and regulatory T cells actively suppress NK cell-dependent anticancer immunity. Here, we review the metabolic and cellular barriers that inhibit NK cells in solid neoplasms as we discuss potential strategies to circumvent such obstacles towards superior therapeutic activity.
Insights
Natural killer (NK) cells show promise for leukemia but struggle in solid tumors. This review explores the tumor microenvironment
Area of Science:
- Immunology
- Cancer Biology
- Cellular Metabolism
Background:
- Natural killer (NK) cells are innate lymphocytes with cytotoxic potential, emerging as promising anticancer therapeutics.
- While NK cell infusions yield positive results in leukemia patients, their efficacy against solid tumors remains limited.
- Factors within the tumor microenvironment (TME) hinder NK cell infiltration, persistence, and activation.
Purpose of the Study:
- To review the metabolic and cellular barriers inhibiting NK cell activity in solid tumors.
- To discuss strategies for overcoming these obstacles to enhance NK cell-based cancer therapy.
Main Methods:
- Literature review of preclinical and clinical data.
- Analysis of factors affecting NK cell function in the TME.
- Exploration of therapeutic strategies to enhance NK cell efficacy.
Main Results:
- The TME presents metabolic challenges (hypoxia, adenosine, ROS, prostaglandins) that impair NK cell function.
- Cellular components within the TME (fibroblasts, macrophages, MDSCs, Tregs) actively suppress NK cell-mediated immunity.
- Inadequate tumor infiltration and persistence are key limitations for NK cell therapy in solid malignancies.
Conclusions:
- Overcoming metabolic and cellular suppressive mechanisms in the TME is crucial for improving NK cell therapy.
- Developing strategies to enhance NK cell infiltration, activation, and persistence can lead to superior therapeutic outcomes in solid tumors.
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