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Adaptive Immunity in Genitourinary Cancers.

Madhuri Koti1, Trinity Bivalacqua2, Peter C Black3

  • 1Department of Biomedical and Molecular Sciences, Cancer Research Institute, Queen's University, Kingston, ON, Canada.

European Urology Oncology
|April 17, 2023
PubMed
Summary
This summary is machine-generated.

Immune checkpoint inhibitors show poor response in prostate cancer. Factors like aging, tumor mutations, and immune cell states impact outcomes, necessitating further research for better immunotherapy strategies in genitourinary cancers.

Keywords:
Bladder cancerGenitourinary cancersImmune checkpoint inhibitorKidney cancerProstate cancerTertiary lymphoid structureTumor immune microenvironment

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Area of Science:

  • Oncology
  • Immunology
  • Genitourinary Cancers

Background:

  • Urothelial and renal cell cancers respond modestly to immune checkpoint inhibitors (ICIs).
  • Prostate cancer exhibits poor response rates to novel immunotherapies, with underlying factors yet to be fully elucidated.
  • Understanding adaptive immunity is crucial for improving ICI efficacy in genitourinary (GU) cancers.

Purpose of the Study:

  • To review the literature on adaptive immune events in GU cancer progression and therapeutic response.
  • To describe key physiological events influencing antitumor immunity in GU cancers.
  • To highlight advancements in understanding mediators of adaptive immunity against GU cancers.

Main Methods:

  • A nonsystematic, collaborative narrative review was conducted.
  • Literature was reviewed to identify critical mediators of antitumor adaptive immunity in GU cancers.
  • Pre- and post-treatment immunological events were discussed for urothelial, renal cell, and prostate cancers.

Main Results:

  • Aging-associated immune decline significantly impacts immunotherapy outcomes.
  • Tumor mutational burden, specific gene mutations (e.g., KDM6A, PTEN, TP53), and immune cell localization influence response.
  • Immune cell infiltration profiles and tertiary lymphoid structures (TLSs) may serve as prognostic and predictive biomarkers.

Conclusions:

  • Significant knowledge gaps remain in understanding the tumor immune landscape for GU cancers.
  • Further research into host and tumor factors will improve immunotherapy efficacy.
  • A comprehensive understanding will enable precision immunotherapy, optimized drug sequencing, and improved therapeutic responses.