[Immunotherapy in epithelial ovarian carcinoma: hope and reality].
BACKGROUND
Epithelial ovarian carcinoma (EOC) has a worst prognosis with little progress in terms of survival for the last two decades. Immunology received little interest in EOC in the past, but now appears very important in the natural history of this cancer. This review is an EOC immunology state of art and focuses on the place of immunotherapy in future.


METHODS
A systematic review of published studies was performed. Medline baseline interrogation was performed with the following keywords: "Ovarian carinoma, immunotherapy, T-lymphocyte, regulator T-lymphocyte, dendritic cells, macrophage, antigen, chemotherapy, surgery, clinical trials". Identified publications (English or French) were assessed for the understanding of EOC immunology and the place of conventional treatment and immunotherapy strategy.


RESULTS
Intratumoral infiltration by immune cells is a strong prognotic factor in EOC. Surgery and chemotherapy in EOC decrease imunosuppression in patients. The antitumoral immunity is a part of the therapeutic action of surgery and chemotherapy. Until now, immunotherapy gave some disappointing results, but the new drugs that target the tolerogenic tumoral microenvironnement rise and give a new hope in the treatment of cancer.


CONCLUSIONS
Immunology controls the EOC natural history. The modulation of immunosuppressive microenvironment associated with the stimulation of antitumoral immunity could be the next revolution in the treatment of cancer.
Service de chirurgie gynécologique, centre hospitalier universitaire de Rennes, 35000 Rennes, France; Faculté de médecine, université de Rennes 1, 35000 Rennes, France; Inserm, UMR991, 35000 Rennes, France. Electronic address: vincent.lavoue@gmail.com.
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Lavoué
Service de chirurgie gynécologique, centre hospitalier universitaire de Rennes, 35000 Rennes, France.
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Foucher
Service d'anatomo-pathologie, centre hospitalier universitaire de Rennes, 35000 Rennes, France.
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Henno
Service de chirurgie gynécologique, centre hospitalier universitaire de Rennes, 35000 Rennes, France.
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Bauville
Faculté de médecine, université de Rennes 1, 35000 Rennes, France; Inserm, UMR991, 35000 Rennes, France; Service de biologie cellulaire, centre hospitalier universitaire de Rennes, 35000 Rennes, France.
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Catros
Faculté de médecine, université de Rennes 1, 35000 Rennes, France; Inserm, UMR991, 35000 Rennes, France; Service de biologie cellulaire, centre hospitalier universitaire de Rennes, 35000 Rennes, France.
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Cabillic
Service de chirurgie gynécologique, centre hospitalier universitaire de Rennes, 35000 Rennes, France; Faculté de médecine, université de Rennes 1, 35000 Rennes, France.
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Levêque
D000077216:Carcinoma, Ovarian Epithelial; D005260:Female; D006801:Humans; D007167:Immunotherapy / Q000379:methods; D009375:Neoplasms, Glandular and Epithelial / Q000276:immunology / Q000628:therapy*; D010051:Ovarian Neoplasms / Q000276:immunology / Q000628:therapy*; D016896:Treatment Outcome
Cancer de l’ovaire; Immunologie; Immunology; Immunomodulation; Immunomudulation; Immunotherapy; Immunothérapie; Lymphocyte; Microenvironment; Microenvironnement; Ovarian carcinoma