Opportunities and challenges for cancer immunotherapy based on antigen cross-presentation

Two immunological events usually occur in anti-tumor immunity. On the one hand, tumor cells present endogenous tumor antigen to activate CD8⁺ cytotoxic T lymphocytes (CTLs) via direct presentation. On the other hand, professional antigen presenting cells (APCs), such as dendritic cells (DCs), take up exogenous tumor antigen for the CTL activation through cross-presentation (XPT). However, in actual tumor settings in vivo, tumor cells not only reduce their own antigen direct presentation by down-regulating major histocompatibility complex (MHC) I molecules, but also impair the XPT from DCs by producing immunosuppressive factors such as prostaglandin E2 (PGE2), vascular endothelial growth factor (VEGF), interleukin (IL)-6, and IL-10, and so on, leading to the failure of immunosurveillance and subsequent tumor growth.

We first summarize the latest studies on different mechanisms of XPT, before different types of DC vaccines and recent advances in XPT-based cancer immunotherapeutic strategies are described.

Emerging studies have elucidated multiple pathways and molecular regulators of XPT in DCs. Different types of DC vaccines have been developed to optimize XPT and improve CTL activation. Furthermore, innovative strategies targeting immunosuppressive factors in the tumor microenvironment (TME) have shown promise in enhancing the efficacy of XPT-based immunotherapies.

Deep insight of XPT in DCs and its affecting factors in tumor immunology will hopefully lead to better therapeutic translation in clinical treatment of tumor, the fatal disease that has threatened human life for centuries.