cancerimmunologi

Cancer immunology, or cancerimmunologi in Danish, is the study of how the immune system detects, interacts with, and sometimes fails to control cancer. The field encompasses basic mechanisms of tumor immunosurveillance and immunoediting, the role of the tumor microenvironment, and the development of immunotherapies that harness or modify immune responses to cancer.

Key components include both innate and adaptive immunity. Natural killer cells, dendritic cells, macrophages, and neutrophils interact with T and B lymphocytes, particularly cytotoxic T cells that recognize tumor antigens and neoantigens presented by MHC molecules. Tumors often create an immunosuppressive milieu through regulatory T cells, myeloid-derived suppressor cells, and inhibitory cytokines, which can blunt anti-tumor responses.

Immunoediting describes three phases: elimination (immune clearance of nascent tumors), equilibrium (a balance between immune pressure and tumor growth), and escape (tumor variants that resist immunity and progress).

Clinically, immunology has led to immunotherapies that improve outcomes for some patients. Approved approaches include immune checkpoint inhibitors (targeting CTLA-4 or PD-1/PD-L1), adoptive cell therapies such as CAR-T cells and tumor-infiltrating lymphocytes, cancer vaccines, and oncolytic viruses. Responses vary across cancer types, and therapy can cause immune-related adverse events affecting multiple organs.

Diagnostics and biomarkers support patient selection and response monitoring. PD-L1 expression, microsatellite instability, tumor mutational burden, and patterns of immune infiltration inform treatment decisions. Challenges include tumor heterogeneity, adaptive resistance, and managing toxicities. Ongoing research aims to expand benefits through combination strategies, novel targets, and improved understanding of the tumor–immune interface.