Abstract
Lung cancer is the leading cause of cancer deaths worldwide and one of the most common types of cancers. The limited success of chemotherapy and radiotherapy regimes have highlighted the need to develop new therapies like antitumor immunotherapy. CD8+ T-cells represent a major arm of the cell-mediated anti-tumor response and a promising target for developing T-cell-based immunotherapies against lung cancer. Lung tumors, however, have been considered to possess poor immunogenicity; even so, lung tumor-specific CD8+ T-cell clones can be established that possess cytotoxicity against autologous tumor cells. This paper will focus on the alterations induced in CD8+ T-cells by lung cancer. Although memory CD8+ T-cells infiltrate lung tumors, in both tumor-infiltrating lymphocytes (TILs) and malignant pleural effusions, these cells are dysfunctional and the effector subset is reduced. We propose that chronic presence of lung tumors induces dysfunctions in CD8+ T-cells and sensitizes them to activation-induced cell death, which may be associated with the poor clinical responses observed in immunotherapeutic trials. Getting a deeper knowledge of the evasion mechanisms lung cancer induce in CD8+ T-cells should lead to further understanding of lung cancer biology, overcome tumor evasion mechanisms, and design improved immunotherapeutic treatments for lung cancer.
Highlights
Lung cancer is the leading cause of cancer-related mortality in developed countries and the second leading cause of death in countries with emerging economies
NSCLC accounts for approximately 85% of all lung cancer cases and includes three histological subtypes: squamous cell carcinoma, adenocarcinoma, and large cell carcinoma
More recently, AlShibli et al [64] showed that high densities of CD8+ Tcells in the stroma significantly correlated with an improved survival in patients with NSCLC
Summary
Lung cancer is the leading cause of cancer-related mortality in developed countries and the second leading cause of death in countries with emerging economies. NSCLC accounts for approximately 85% of all lung cancer cases and includes three histological subtypes: squamous cell carcinoma, adenocarcinoma, and large cell carcinoma. Most lung cancer diagnoses are performed at advanced stages of lung malignancy and 5-year survival rates remain low [4, 5]. The multifaceted nature of the immune escape mechanisms of lung tumor cells is a major obstacle to the potential application of immunotherapy in lung cancer patients. There is a need, to elucidate and characterize these immune escape mechanisms to develop strategies to counteract them, enhancing the efficacy of T-cell-based immunotherapies. We focus on the alterations induced by lung tumors on CD8+ T-cells
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