4.7 Review

Systemic immunity in cancer

Journal

NATURE REVIEWS CANCER
Volume 21, Issue 6, Pages 345-359

Publisher

NATURE PORTFOLIO
DOI: 10.1038/s41568-021-00347-z

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Understanding systemic immune landscape beyond the tumour microenvironment is crucial in assessing the effectiveness of immunotherapy in cancer treatment. Despite the potential of immunotherapy to induce new immune responses, compromised immune responses in individuals with tumors may limit its efficacy.
An improved understanding of tumour immunology and therapy must assess the systemic immune landscape beyond the tumour microenvironment. This Review outlines peripheral immune cell reorganization in response to tumour growth and therapy, their contribution to immunotherapy responses and their potential as diagnostic or predictive biomarkers. Immunotherapy has revolutionized cancer treatment, but efficacy remains limited in most clinical settings. Cancer is a systemic disease that induces many functional and compositional changes to the immune system as a whole. Immunity is regulated by interactions of diverse cell lineages across tissues. Therefore, an improved understanding of tumour immunology must assess the systemic immune landscape beyond the tumour microenvironment (TME). Importantly, the peripheral immune system is required to drive effective natural and therapeutically induced antitumour immune responses. In fact, emerging evidence suggests that immunotherapy drives new immune responses rather than the reinvigoration of pre-existing immune responses. However, new immune responses in individuals burdened with tumours are compromised even beyond the TME. Herein, we aim to comprehensively outline the current knowledge of systemic immunity in cancer.

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