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Sex, immunity, and cancer

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ELSEVIER
DOI: 10.1016/j.bbcan.2021.188647

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Sexual dimorphism; Genomics; Biomarkers; Tumor mutational burden

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The composition of the tumor microenvironment is influenced by the interaction between tumoral and host factors, with sex differences mainly regulated by sex hormones affecting tumor-host interaction and immune system sexual dimorphism. Sex-specific differences exist in cancer susceptibility, treatment response, and the importance of sex as a biomarker in cancer therapy has recently gained attention due to varying results in immunotherapy treatment.
The composition of the tumor microenvironment is the complex result of the interaction between tumoral and host factors. Since there are several differences in the regulation of gene circuits between sexes, mainly influenced by sex hormones, the tumor-host interaction presents some differences, leading tumors to evolve under different conditions. Nowadays, it is well known the existence of sexual dimorphism in the regulation of the immune system, where women present an improved immunity to various infectious agents and, on the other hand, a higher incidence of autoimmune diseases than men. In oncology, differences in cancer susceptibility, response to treatment, and clinical outcomes between men and women patients are well known. Recently, sexspecific differences have also been reported in mutations in driver genes and the prognostic value of several biomarkers. Sex has been a widely forgotten biomarker in cancer therapy, but it has recently acquired great relevance due to the different results seen in immunotherapy treatment.

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