Publications

Journal Article Review Epublish

PubMed: 40746533 DOI: 10.3389/fimmu.2025.1586315

The immune microenvironment in endometrial carcinoma: mechanisms and therapeutic targeting.

Front Immunol 16:1586315

Authors: Yilin Wang, Nana Liu, Xiangcui Guo, Ruobing Han, Jin Bai, Jiateng Zhong, Qianqing Wang

Affiliations

  • Xinxiang Medical University, Xinxiang, China. The Fourth Clinical College, Xinxiang Medical University, Xinxiang, China.
  • Xinxiang Medical University, Xinxiang, China. The Fourth Clinical College, Xinxiang Medical University, Xinxiang, China. Henan Medical Key Laboratory for Immunology and Targeted Therapy, Xinxiang, China.
  • School of Basic Medicine, Xuzhou Medical University, Xuzhou, China.
  • School of Basic Medicine, Xinxiang Medical University, Xinxiang, China.

Abstract

Endometrial carcinoma (EC) represents one of the most prevalent malignancies within the female reproductive system. The frequency of its occurrence is on the rise annually, and patients diagnosed at advanced stages face a less favorable prognosis. Recent studies have highlighted the significant influence of the tumor immune microenvironment (TME) on the initiation, progression, metastasis, and therapeutic resistance of endometrial cancer. The TME encompasses various components such as tumor-associated macrophages (TAMs), myeloid-derived suppressor cells (MDSCs), cancer-associated fibroblasts (CAFs), immune cells, and the extracellular matrix (ECM). These elements contribute to an immunosuppressive milieu by secreting cytokines, extracellular vesicles (EVs), and engaging immune checkpoint pathways like PD-1/PD-L1, thereby supporting tumor immune evasion and resistance to treatment. This review synthesizes current understanding of the EC-TME, focusing on the distinct roles and interactions of its key constituents within the context of EC biology. Furthermore, we explore the rationale and progress for novel therapeutic strategies targeting the TME, such as immune checkpoint inhibitors, combination therapies, and nano delivery systems leveraging EVs, aiming to provide insights for improving EC patient outcomes.

MeSH

Cells, Myeloid-Derived Suppressor Cells, Neoplasms, Immunotherapy, Immune System Diseases, Therapeutics, Immune Evasion