Tumors intricately shape a highly immunosuppressive microenvironment, hampering effective antitumor immune responses through diverse mechanisms. Consequently, achieving optimal efficacy in cancer immunotherapy necessitates the reorganization of the tumor microenvironment and restoration of immune responses. Bladder cancer, ranking as the second most prevalent malignant tumor of the urinary tract, presents a formidable challenge. Immunotherapeutic interventions including intravesical BCG and immune checkpoint inhibitors such as atezolizumab, avelumab, and pembrolizumab have been implemented. However, a substantial unmet need persists as a majority of bladder cancer patients across all stages do not respond adequately to immunotherapy. Bladder cancer establishes a microenvironment that can actively hinder an efficient anti-tumor immune response. A deeper understanding of immune evasion mechanisms in bladder cancer will aid in suppressing recurrence and identifying viable therapeutic targets. This review seeks to elucidate mechanisms of immune evasion specific to bladder cancer and explore novel pathways and molecular targets that might circumvent resistance to immunotherapy.
International journal of molecular sciences. 2024 Mar 07*** epublish ***
Juhyun Shin, Jeong Won Park, Seon Young Kim, Jun Ho Lee, Wahn Soo Choi, Hyuk Soon Kim
Department of Health Sciences, The Graduate School of Dong-A University, Busan 49315, Republic of Korea., Department of Korean Medicine, College of Korean Medicine, Woosuk University, Jeonju 54986, Republic of Korea., Department of Immunology, College of Medicine, Konkuk University, Chungju 27478, Republic of Korea.