The immune symphony of endometrial cancer
The Immune System as an Ally Against Endometrial Cancer
Our immune system protects us every day against viruses, bacteria, and other harmful invaders. But can it also protect us against cancer? In endometrial cancer, there are indications that it can. Some tumor cells carry changes in their DNA that make them more recognizable to the immune system. Yet, the immune system is not always able to eliminate the tumor.
In this thesis, Koen Brummel investigated how the immune system and endometrial cancer interact, and how this knowledge can be used to improve cancer treatment. Among other things, I studied immune cells that infiltrate the tumor. I also investigated so-called tertiary lymphoid structures: small ‘immune centers’ that can develop around or within a tumor. Here, different types of immune cells can work together to recognize and attack cancer cells.
An important part of this research focused on immunotherapy. This treatment can be thought of as releasing the brakes on the immune system, allowing immune cells to attack the tumor more effectively. In women with a specific type of endometrial cancer, in which DNA repair is impaired, we investigated whether immunotherapy could be given before surgery. In some patients, this led to a substantial reduction in the tumor and, in some cases, even to the complete disappearance of visible tumor cells.
These findings show that the immune system plays an important role in endometrial cancer. By gaining a better understanding of why some tumors respond to immunotherapy while others do not, we may be able to predict more accurately which treatment is most suitable for each patient in the future.