Review
Copyright ©2013 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Stem Cells. Oct 26, 2013; 5(4): 149-162
Published online Oct 26, 2013. doi: 10.4252/wjsc.v5.i4.149
Aiming to immune elimination of ovarian cancer stem cells
Jiabo Di, Tjitske Duiveman-de Boer, Carl G Figdor, Ruurd Torensma
Jiabo Di, Tjitske Duiveman-de Boer, Carl G Figdor, Ruurd Torensma, Department of Tumor Immunology, Nijmegen Centre for Molecular Life Sciences, Radboud University Nijmegen Medical Centre, GA 6525 Nijmegen, The Netherlands
Author contributions: Di J and Duiveman-de Boer T performed experiments; Di J, Figdor CG and Torensma R designed research and wrote the paper.
Supported by The Dutch government to the Netherlands Institute for Regenerative Medicine, No. FES0908
Correspondence to: Ruurd Torensma, PhD, Department of Tumor Immunology, Nijmegen Centre for Molecular Life Sciences, Radboud University Nijmegen Medical Centre, Geert Grooteplein 28, GA 6525 Nijmegen, The Netherlands. r.torensma@ncmls.ru.nl
Telephone: +31-24-3617600 Fax: +31-24-3540339
Received: February 18, 2013
Revised: June 19, 2013
Accepted: July 18, 2013
Published online: October 26, 2013
Processing time: 254 Days and 16 Hours
Abstract

Ovarian cancer accounts for only 3% of all cancers in women, but it causes more deaths than any other gynecologic cancer. Treatment with chemotherapy and cytoreductive surgery shows a good response to the therapy. However, in a large proportion of the patients the tumor grows back within a few years. Cancer stem cells, that are less responsive to these treatments, are blamed for this recurrence of disease. Immune therapy either cellular or humoral is a novel concept to treat cancer. It is based on the notice that immune cells invade the tumor. However, the tumor invest heavily to escape from immune elimination by recruiting several immune suppressive mechanisms. These processes are normally in place to limit excessive immune activation and prevent autoimmune phenomena. Here, we discuss current knowledge about the immune (suppressive) status in ovarian cancer. Moreover, we discuss the immunological targets of ovarian cancer stem cells.

Keywords: Ovarian cancer; Cancer stem cell; Immune therapy; Immune suppression; Tumor microenvironment

Core tip: Ovarian cancer harbors, at a low frequency, cancer stem cells. Those cancer stem cells express stem cell specific antigens. Natural immunity against those antigens exists but is hampered by the suppressive microenvironment that the tumor creates. Erasing this suppressive microenvironment will make immunological elimination of those cancer stem cells is an attractive treatment option.