title: Review article: antitumoural immunity in colorectal cancer - current and potential future implications in clinical practice.
abstract: BACKGROUND
  Most of the current research in gastrointestinal oncology is focused on biology of cancer itself, but there is growing interest in the patient's immune system response and its relation with cancer cells.
  
  
  OBJECTIVE
  To review the impact of the antitumoural immune response on epidemiology, prognosis and treatment of colorectal cancer.
  
  
  METHODS
  Search of the literature published in English using the PubMed database.
  
  
  RESULTS
  The role of the immune system in the antitumoural immunosurveillance is clearly supported by the increased incidence of colorectal cancer and adenomatous polyps in immunosuppressed patients. Moreover, the degree of infiltration of the tumours by the immune cells has been shown to be a strong prognostic factor of both disease recurrence and survival. The immune system plays an important role in the chemotherapy-induced cell death. New therapeutic strategies targeting the antitumoural immunity are being currently investigated with promising results.
  
  
  CONCLUSIONS
  Better knowledge of antitumoural immune system can have a major impact on patients' management in daily clinical practice. Colorectal cancer screening is an important issue in immunosuppressed patients, and recommendations should be refined for selected high-risk patients. The use of an immune score to guide the therapeutic strategies in the adjuvant setting should be supported. Further and larger clinical trials are necessary to accelerate the development of innovative immune therapies.
authors.affiliation: Institut des Maladies de l'Appareil Digestif & Digestive Oncology Unit, CHU de Nantes, Nantes Cedex, France.
authors.forename: C
authors.initials: C
authors.lastname: Koudougou
authors.forename: M
authors.initials: M
authors.lastname: Bonneville
authors.forename: T
authors.initials: T
authors.lastname: Matysiak-Budnik
authors.forename: Y
authors.initials: Y
authors.lastname: Touchefeu
mesh_terms: D016588:Anticarcinogenic Agents / Q000276:immunology; D000951:Antigens, Neoplasm / Q000276:immunology*; D015179:Colorectal Neoplasms / Q000276:immunology*; D006801:Humans; D007107:Immune System / Q000276:immunology; D007109:Immunity / Q000276:immunology; D016867:Immunocompromised Host / Q000276:immunology*; D007167:Immunotherapy / Q000379:methods; D011379:Prognosis
chemical_list: D016588:Anticarcinogenic Agents; D000951:Antigens, Neoplasm