Journal
LABORATORY INVESTIGATION
Volume 97, Issue 6, Pages 669-697Publisher
NATURE PUBLISHING GROUP
DOI: 10.1038/labinvest.2017.25
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Funding
- National Institutes of Health National Heart Lung Blood Institute [P01 HL107146]
- Team Jobie Fund
- Faye Geronemus Leukemia Research Fund
- Milstein Research Scholar Award from American Skin Association
- Dermatology Foundation
- Fund to Sustain Research Excellence from Brigham Research Institute
- Merck-Melanoma Research Alliance
- V Foundation for Cancer Research
- Rochester Melanoma Action Group/Outrun the Sun
- Compass Therapeutics LLC
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Advances in cancer immunotherapy have offered new hope for patients with metastatic disease. This unfolding success story has been exemplified by a growing arsenal of novel immunotherapeutics, including blocking antibodies targeting immune checkpoint pathways, cancer vaccines, and adoptive cell therapy (ACT). Nonetheless, clinical benefit remains highly variable and patient-specific, in part, because all immunotherapeutic regimens vitally hinge on the capacity of endogenous and/or adoptively transferred T-effector (T-eff) cells, including chimeric antigen receptor (CAR) T cells, to home efficiently into tumor target tissue. Thus, defects intrinsic to the multi-step T-cell homing cascade have become an obvious, though significantly underappreciated contributor to immunotherapy resistance. Conspicuous have been low intralesional frequencies of tumor-infiltrating T-lymphocytes (TILs) below clinically beneficial threshold levels, and peripheral rather than deep lesional TIL infiltration. Therefore, a T-eff cell 'homing deficit' may arguably represent a dominant factor responsible for ineffective immunotherapeutic outcomes, as tumors resistant to immune-targeted killing thrive in such permissive, immune-vacuous microenvironments. Fortunately, emerging data is shedding light into the diverse mechanisms of immune escape by which tumors restrict T-eff cell trafficking and lesional penetrance. In this review, we scrutinize evolving knowledge on the molecular determinants of T-eff cell navigation into tumors. By integrating recently described, though sporadic information of pivotal adhesive and chemokine homing signatures within the tumor microenvironment with better established paradigms of T-cell trafficking under homeostatic or infectious disease scenarios, we seek to refine currently incomplete models of T-eff cell entry into tumor tissue. We further summarize how cancers thwart homing to escape immune-mediated destruction and raise awareness of the potential impact of immune checkpoint blockers on T-eff cell homing. Finally, we speculate on innovative therapeutic opportunities for augmenting T-eff cell homing capabilities to improve immunotherapy-based tumor eradication in cancer patients, with special focus on malignant melanoma.
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