title: Leveraging the immune system to treat advanced thyroid cancers.
abstract: Inflammation has long been associated with the thyroid and with thyroid cancers, raising seminal questions about the role of the immune system in the pathogenesis of advanced thyroid cancers. With a growing understanding of dynamic tumour-immune cell interactions and the mechanisms by which tumour cells evade antitumour immunity, the field of cancer immunotherapy has been revolutionised. In this Review, we provide evidence to support the presence of an antitumour immune response in advanced thyroid cancers linked to cytotoxic T cells and NK cells. This antitumour response, however, is likely blunted by the presence of immunosuppressive pathways within the microenvironment, facilitated by tumour-associated macrophages or increased expression of negative regulators of cytotoxic T-cell function. Current and future efforts to incorporate immune-based therapies into existing tumour cell or endothelial-derived therapies-eg, with kinase inhibitors targeting tumour-associated macrophages or antibodies blocking negative regulators on T cells-could provide improved and durable responses for patients with disease that is otherwise refractory to treatment.
authors: Department of Medicine, Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Denver, Aurora, CO, USA; University of Colorado Cancer Center, University of Colorado Denver, Aurora, CO, USA.
authors: Jena D
authors: JD
authors: French
authors: Division of Medical Oncology, Mayo Clinic, Rochester, MN, USA.
authors: Keith
authors: K
authors: Bible
authors: Department of Internal Medicine II, University Hospital of Munich, Ludwig-Maximilians-University, Munich, Germany.
authors: Christine
authors: C
authors: Spitzweg
authors: Department of Medicine, Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Denver, Aurora, CO, USA; Department of Pathology, University of Colorado Denver, Aurora, CO, USA; University of Colorado Cancer Center, University of Colorado Denver, Aurora, CO, USA.
authors: Bryan R
authors: BR
authors: Haugen
authors: Division of Medical Oncology, Mayo Clinic, Rochester, MN, USA; Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, MN, USA. Electronic address: ryder.mabel@mayo.edu.
authors: Mabel
authors: M
authors: Ryder
mesh_terms: D006801:Humans; D056747:Immunomodulation; D007167:Immunotherapy / Q000639:trends*; D007694:Killer Cells, Natural / Q000502:physiology; D008264:Macrophages / Q000502:physiology; D013601:T-Lymphocytes / Q000502:physiology; D013964:Thyroid Neoplasms / Q000276:immunology / Q000628:therapy*