Cancer immunoediting includes three phases: elimination, equilibrium and escape. Early on, the body senses cancer and offers a potent immune response to eliminate it. “But cancer didn’t get to be where cancer is by being nonplastic, nondynamic or unable to evolve. Cancer will do everything it can to shake that negative force,” said Dr. Rosen. During equilibrium, cancer cells move, and the immune response follows to fight it—a highly dynamic and plastic process. However, the cancer is not gone, but unable to grow and spread due to the immune forces. As time goes by, cancer may become more mutated, dealing the immune system a “death blow,” and escape to cause damage, Dr. Rosen said.
In systemic sclerosis patients with autoantibodies to POLR3 (RNA polymerase III), the immune response may be due to a mutated autoantigen, said Dr. Rosen. Immunoediting occurs in human tumors as a potent anticancer mechanism, and this mechanism may help protect these patients by either killing the cancer or keeping it in the equilibrium phase, he said.
Susan Bernstein is a freelance medical journalist based in Atlanta.
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