Un rôle très précoce du micro-environnement immun dès les premières étapes de la carcinogenèse bronchique: A very early role of the immune microenvironment from the first stages of bronchial carcinogenesis

Abstract

A better understanding of early carcinogenesis would provide tools to stratify the risk of progression from pre-invasive lesions to cancer and to propose early intervention strategies. To this end, the multistage model of pre-squamous bronchial cancer is intensively studied. New technologies allow broad-spectrum analysis of lesions that are rare and small. Early research focused on the intrinsic abnormalities of epithelial cells that progressively acquire the basic oncological characteristics. Several recent studies analyzed the stroma and immune microenvironment at these early stages. In low-grade and regressing lesions, the host immune response is triggered and rapidly intensifies. In high-grade lesions, which progress to cancer, immune escape occurs before invasion with notably the increase of immune checkpoint co-inhibitory molecules and of suppressive cytokines, the reorganization of the microenvironment, and alterations in antigen presentation machinery. These discoveries now open the prospect of better stratifying individuals at risk of lung cancer but also of broadening the applications of immunomodulatory treatments to intercept cancer with secondary prevention strategies.© 2022 SPLF. Published by Elsevier Masson SAS. All rights reserved.