MDSCs in cancer: Conceiving new prognostic and therapeutic targets

• MDSCs are a heterogeneous myeloid cell population that promotes tumor progression.
• TDFs induce MDSC differentiation and function through selective molecular pathways.
• Therapeutic approaches blocking MDSC functions are evaluated in clinical trials.
• MDSC subsets have a prognostic value to predict prognosis in cancer patients.
• Innovative technologies are required to characterize MDSCs in cancer patients.

The incomplete clinical efficacy of anti-tumor immunotherapy can depend on the presence of an immunosuppressive environment in the host that supports tumor progression. Tumor-derived cytokines and growth factors induce an altered hematopoiesis that modifies the myeloid cell differentiation process, promoting proliferation and expansion of cells with immunosuppressive skills, namely myeloid derived suppressor cells (MDSCs). MDSCs promote tumor growth not only by shaping immune responses towards tumor tolerance, but also by supporting several processes necessary for the neoplastic progression such as tumor angiogenesis, cancer stemness, and metastasis dissemination. Thus, MDSC targeting represents a promising tool to eliminate host immune dysfunctions and increase the efficacy of immune-based cancer therapies.

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