AUTHOR=Bruno Valentina , Corrado Giacomo , Baci Denisa , Chiofalo Benito , Carosi Maria Antonia , Ronchetti Livia , Piccione Emilio , Albini Adriana , Noonan Douglas M. , Piaggio Giulia , Vizza Enrico 

TITLE=Endometrial Cancer Immune Escape Mechanisms: Let Us Learn From the Fetal–Maternal Interface

JOURNAL=Frontiers in Oncology

VOLUME=Volume 10 - 2020

YEAR=2020

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2020.00156

DOI=10.3389/fonc.2020.00156

ISSN=2234-943X

ABSTRACT=The immune escape mechanisms at the base of tumor progression in endometrial cancer mimic immune tolerance mechanisms occurring at maternal-fetal interface. The biological and immunological processes behind maternal-fetal interface are finely tuned in time and space during embryo implantation and subsequent pregnancy stages, conversely those behind cancer progression  are often aberrant. The environment composition at the maternal-fetal interface parallels with pro-tumor microenvironment identified in many cancers, pointing the possibility for the use of maternal fetal interface as a model to depict immune therapeutic targets in cancer. The framework of cancer environment signatures involved in immune adaptations, precisely timed in cancer progression, could reveal a specific “immune clock” in endometrial cancer, which might guide clinicians in patients risk class assessment, diagnostic work-up, management, surgical and therapeutic approach and surveillance strategies. Here, we review studies approaching this hypothesis focusing on what is known so far about onco-fetal similarities in immunity with the idea to individualize personalized immunotherapy targets, through the down-regulation of the immune escape stage or the reactivation of the pro-inflammatory processes suppressed by the tumor.