Effect of neoadjuvant chemotherapy on the immune microenvironment of gynaecological tumours

Abstract

Purpose: To assess the impact of neoadjuvant chemotherapy (NACT) on the tumor immune microenvironment (TIME) in gynaecological tumors, with a focus on understanding the potential for enhanced combination therapies.

Methods: We systematically queried the PubMed, Embase, and Cochrane databases, encompassing reviews, clinical trials, and case studies, to undertake a thorough analysis of the impact of NACT on the TIME of gynaecological tumors.

Results: NACT induces diverse immune microenvironment changes in gynaecological tumors. In cervical cancer, NACT boosts immune-promoting cells, enhancing tumor clearance. Ovarian cancer studies yield variable outcomes, influenced by patient-specific factors and treatment regimens. Limited research exists on NACT’s impact on endometrial cancer’s immune microenvironment, warranting further exploration. In summary, NACT-induced immune microenvironment changes display variability. Clinical trials highlight personalized immunotherapy’s positive impact on gynaecological tumor prognosis, suggesting potential avenues for future cancer treatments. However, rigorous investigation is needed to determine the exact efficacy and safety of combining NACT with immunotherapy.

Conclusion: This review provides a solid foundation for the development of late-stage immunotherapy and highlights the importance of therapeutic strategies targeting immune cells in TIME in anti-tumor therapy.

KEY MESSAGES

• The abnormal tumour microenvironment in gynaecological tumours can impede the penetration and accumulation of chemotherapeutic drugs, leading to poorer drug therapy efficacy.

• Neoadjuvant chemotherapy can improve the surgical resection rate of patients while regulating the ratio of each immune cell subpopulation to achieve the regulation of the tumour microenvironment, thus achieving anti-tumour effects.

• Based on the immune variability of patients after neoadjuvant chemotherapy, selecting the most suitable individualized immunotherapy will become a promising new therapy.

Keywords:

• Tumour immune microenvironment
• gynaecological tumours
• neoadjuvant chemotherapy
• immunotherapy

Author contributions

Jing Xue: collection of literature and drafting the paper. Xia Yan: conception and design, revising the paper, final approval of the version to be published. Nan li: revising the paper critically for intellectual content. Menghan Wu: revising the paper critically for intellectual content. Qin Ding: revising the paper critically for intellectual content and the final approval of the version to be published. Jianbo Song: conception and design, revising the paper critically for intellectual content and the final approval of the version to be published. All authors agree to be accountable for all aspects of the paper.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

Data sharing is not applicable to this article as no new data were created or analysed in this study.

Additional information

Funding

This study was funded by basic research project of Shanxi province (No. 202103021224365).