Immunobiology of cholangiocarcinoma

Recent literature has significantly advanced our knowledge and understanding of the tumour immune microenvironment of cholangiocarcinoma. Detailed characterisation of the immune landscape has defined new patient subtypes. While not utilised in clinical practice yet, these novel classifications will help inform decisions regarding immunotherapeutic approaches. Suppressive immune cells, such as tumour-associated macrophages and myeloid-derived suppressor cells, form a barrier that shields tumour cells from immune surveillance. The presence of this immunosuppressive barrier in combination with a variety of immune escape mechanisms employed by tumour cells leads to poor tumour immunogenicity. Broad strategies to re-equip the immune system include blockade of suppressive immune cell recruitment to priming cytotoxic effector cells against tumour antigens. While immunotherapeutic strategies are gaining traction for the treatment of cholangiocarcinoma, there is a long road of discovery ahead in order to make meaningful contributions to patient therapy and survival.(c) 2023 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

Automated summary

Recent literature has advanced our understanding of the tumour immune microenvironment and identified new patient subtypes. Inhibitory immune cells and immune escape mechanisms employed by tumour cells contribute to poor tumour immunogenicity. Strategies to block inhibitory immune cell recruitment can re-equip the immune system to target the tumour.