Clinical Perspectives on Targeting of Myeloid Derived Suppressor Cells in the Treatment of Cancer

摘要: Tumors escape immune recognition by several mechanisms, and induction of myeloid derived suppressor cells (MDSC) is thought to play a major role in tumor mediated evasion. MDSC arise from progenitor that do not differentiate into mature dendritic cells, granulocytes, or macrophages, are characterized the ability suppress T cell natural killer function. They increased patients with cancer including renal carcinoma (RCC), their levels have been shown correlate prognosis overall survival. Multiple methods inhibiting MDSCs currently under investigation. These can broadly be categorized (a) promote differentiation mature, non-suppressive (all trans retinoic acid, vitamin D), (b) decrease (sunitinib, gemcitabine, 5-FU, CDDO-Me), (c) functionally inhibit (PDE-5 inhibitors, cyclooxygenase 2 inhibitors). Recently, pre-clinical models combination therapy involving sunitinib plus vaccines and/or adoptive promise inhibition improved outcomes bearing host. Current clinical trials underway RCC assess only impact on outcome, but how this enhance anti-tumor immunity reduce suppression. Decreasing suppression host may improve prolong survival patient population.