REVIEW article

Front. Immunol.

Sec. Cancer Immunity and Immunotherapy

Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1586315

The Immune Microenvironment in Endometrial Carcinoma: Mechanisms and

Provisionally accepted
Yilin  WangYilin Wang1Nana  LiuNana Liu1Xiangcui  GuoXiangcui Guo1Ruobing  HanRuobing Han1Jin  BaiJin Bai2Jiateng  ZhongJiateng Zhong1Qianqing  WangQianqing Wang1*
  • 1The Fourth Clinical College of Xinxiang Medical University, Xinxiang, China
  • 2Xuzhou Medical University, Xuzhou, Jiangsu Province, China

The final, formatted version of the article will be published soon.

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.

Keywords: endometrial carcinoma, Tumor immune microenvironment, Immune Evasion, treatment resistance, targeted therapy, Immunotherapy

Received: 02 Mar 2025; Accepted: 27 Jun 2025.

Copyright: © 2025 Wang, Liu, Guo, Han, Bai, Zhong and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Qianqing Wang, The Fourth Clinical College of Xinxiang Medical University, Xinxiang, China

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