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As we all know, chemotherapy, surgery and other traditional treatment methods, mainly the use of external forces to eliminate tumors.
immunotherapy inhibits tumor growth by enhancing the patient's own immune response.
the incidence of cancer is related to immunity, it is generally believed that the stronger the immunity, the better the effectiveness of cancer treatment.
, however, a recent article published in Nature Communications upends our perception that in some types of cancer immunotherapy, some patients with strong immunity respond less.
Researchers at the University of California, San Diego School of Medicine found that tumor cells in patients with strong immunity did not present autoantigen mutations at first, and that major tissue compatible complexes (MHCs) failed to transmit signals to the immune system to "clear cancer cells", thus restricting cancer immunotherapy.
Doi:10.1038/s41467-020-17981-0 Cancer cells and the surface of infected cells have special molecular markers to "tell" the immune system that it needs to remove these "bad cells."
these molecular markers are molecules called major tissue compatible complexes (MHCs), which are found mainly on the surface of most cells in the body.
to allow the immune system to detect and eliminate "bad cells," tumor cells carry a large number of mutations that occur frequently in these molecular markers.
, because of the presence of more MHCs, patients with stronger immunity, such as young people and women, have better cancer immunotherapy.
but in actual treatment, this is not the case.
To answer this question, the researchers studied genomic information from nearly 10,000 cancer patients in the Cancer Genome Map of the National Institutes of Health in the United States, as well as genomic information from 342 other tumor-type patients obtained from the International Cancer Genome Alliance database and published research.
found no difference in MHC function in age or gender.
the researchers speculated that no significant difference in MHC function between sex and age may have been due to differences in the environment.
MHC's comprehensive gender and age analysis of gender and age, the researchers found that younger and female patients tended to accumulate more cancer-inducing genetic mutations than older and male cancer patients, and that major tissue compatible complexes (MHCs) were less effective at presenting such mutations to the immune system, making young and female patients less effective in cancer immunotherapy.
researchers speculate that the result may be that patients with stronger immunity have stronger immune systems that remove self-antigen cells that exhibit good mutations more thoroughly, leaving behind more tumor cells that perform worse.
means that while the immune system inhibits tumor growth, the malignancy of the tumor gradually strengthens (immune editing), which in turn has a certain boost to tumor development.
The idea is that if tumor cells don't show their own antigen mutations in the first place, then a large number of mutations carried by tumor cells won't appear in the main tissue compatible complex (MHC), which can't "tell" the immune system that it needs to remove "bad cells."
, immunotherapy using checkpoint inhibitor drugs (blocking surface antigens) is "powerless" in this case.
there are more cancer mutations in young and female patients, tumor formation is extremely complex, so there is no one-size-fits-all approach to cancer treatment.
this requires scientists to delve deeper into the interconnected and functioning mechanisms of tumors and the immune system, and then work out the most appropriate treatment for each individual's situation.
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