Cancer Genetics and Epigenetics 2024, Vol.12, No.1, 15-26 http://www.medscipublisher.com/index.php/cge 16 latest achievements and progress of immunotherapy in endometrial cancer, identify future research directions and priorities, and explore how to further improve the efficacy and safety of immunotherapy, And how to address the promotion and popularization of immunotherapy in endometrial cancer. 1 Immunotherapy's Fundamental Principles 1.1 Functionality and mechanisms of the immune system The immune system is a complex defense mechanism within the human body, aimed at protecting the body from pathogens and other abnormal cells. It orchestrates immune responses through the interaction of various cells and molecules. Innate immunity is a nonspecific defense reaction and acts as the body's primary defense against pathogens. It prevents the invasion and spread of pathogens through mechanical barriers (like skin and mucosa) and nonspecific immune cells (such as neutrophils and macrophages). While this immune response is rapid, its disadvantage lies in its lack of specificity, unable to mount precise responses against different pathogens (Bolivar et al., 2018). Adaptive immunity is a highly specific immune response based on lymphocytes (T cells and B cells) activity. It develops in early life through exposure to pathogens or vaccination. When pathogens invade the body, their antigenic components are captured by antigen-presenting cells and presented to T cells. T cells bind to the presented antigen, activating other immune cells like B cells. Activated B cells differentiate into plasma cells, producing antibodies to neutralize pathogens or aid in their clearance (MacKintosh and Crosbie, 2018). 1.2 Classification and mechanisms of immunotherapy Immunotherapy activates or enhances the immune system's responses to combat diseases. Passive immunotherapy uses exogenous antibodies to neutralize pathogens or activate immune cells., while active immunotherapy involves methods like vaccines, cellular immunotherapy, and immune checkpoint inhibitors to activate the patient's immune system. These immunotherapeutic methods have shown significant clinical success and play vital roles in treating various diseases. However, immunotherapy still faces some challenges such as uncertain treatment efficacy and immune-related adverse reactions persist, requiring further research and improvement. Vaccines, containing pathogen antigens or related components, simulate infection to trigger an immune response. They activate the immune cells and antibody production in the body, providing protection against specific pathogens. Vaccines have broad applications, including preventing infectious diseases and certain cancers (Crosbie et al., 2022). Cellular immunotherapy utilizes the patient's own immune cells to target tumor cells. This method includes CAR-T cell therapy and tumor-associated antigen (TAA)-specific T cell therapy. CAR-T cell therapy modifies a patient's T cells to express specific antigen receptors (CARs) that identify and eliminate tumor cells. TAA-specific T cell therapy utilizes the patient's own T cells, amplified and activated to recognize and attack tumor cells. Immune checkpoint inhibitors constitute a class of drugs that boost immune cell attacks on tumor cells by inhibiting negative regulatory signals in the immune system. These inhibitors primarily target immune checkpoint molecules like PD-1, PD-L1, and CTLA-4, restoring immune cell activity to effectively recognize and eliminate tumor cells (Cao et al., 2021). 1.3 Mechanisms of immune checkpoint inhibitors Immune checkpoint inhibitors are a class of drugs that enhance a patient's immune system's ability to attack tumor cells by inhibiting the function of immune checkpoint molecules. These molecules are proteins that negatively regulate the activity of the immune system. Their function is to prevent excessive activation of immune cells, protecting normal cells from immune attacks. Tumor cells can exploit immune checkpoint molecules to evade immune system attacks, thereby promoting tumor growth and spread. The mechanism of action of immune checkpoint inhibitors involves blocking the binding between immune checkpoint molecules and their ligands, releasing the immune system's inhibition and restoring immune cells' ability to kill tumor cells.
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