Cancer and Pregnancy: Parallels in Growth, Invasion, and Immune Modulation and Implications for Cancer Therapeutic Agents

• Published in: Mayo Clinic proceedings Vol. 84; no. 11; pp. 985 - 1000
• Main Authors: HOLTAN, Shernan G, CREEDON, Douglas J, HALUSKA, Paul, MARKOVIC, Svetomir N
• Format: Journal Article
• Language: English
• Published: Rochester, MN Mayo Foundation 01.11.2009; Elsevier, Inc; Elsevier Limited; Mayo Foundation for Medical Education and Research
• Subjects: Academic Medical Centers; Antineoplastic Agents - immunology; Antineoplastic Agents - therapeutic use; Biological and medical sciences; Cancer; Cell Movement - immunology; Cell Proliferation; Cell Transformation, Neoplastic - immunology; Cell Transformation, Neoplastic - pathology; Development and progression; Drug Delivery Systems; Drug therapy; Female; General aspects; Growth; Humans; Immune System Phenomena - immunology; Immune System Phenomena - physiology; Immunologic Factors; Immunological tolerance; Medical sciences; Minnesota; Neoplasm Invasiveness - immunology; Neoplasm Invasiveness - pathology; Neoplasms - drug therapy; Neoplasms - immunology; Neoplasms - pathology; Neovascularization, Pathologic - immunology; Physiological aspects; Pregnancy; Pregnancy - immunology; Pregnancy Trimester, Third; Special; United States; Human; Growth; Immunomodulation; Tumorous infiltration; Metastasis; Malignant tumor; Invasion; Pregnancy; Medicine; Treatment; Female; Woman; Cancer
• ISSN: 0025-6196; 1942-5546
• DOI: 10.1016/s0025-6196(11)60669-1

Many proliferative, invasive, and immune tolerance mechanisms that support normal human pregnancy are also exploited by malignancies to establish a nutrient supply and evade or edit the host immune response. In addition to the shared capacity for invading through normal tissues, both cancer cells and cells of the developing placenta create a microenvironment supportive of both immunologic privilege and angiogenesis. Systemic alterations in immunity are also detectable, particularly with respect to a helper T cell type 2 polarization evident in advanced cancers and midtrimester pregnancy. This review summarizes the similarities between growth and immune privilege in cancer and pregnancy and identifies areas for further investigation. Our PubMed search strategy included combinations of terms such as immune tolerance, pregnancy, cancer, cytokines, angiogenesis, and invasion. We did not place any restrictions on publication dates. The knowledge gained from analyzing similarities and differences between the physiologic state of pregnancy and the pathologic state of cancer could lead to identification of new potential targets for cancer therapeutic agents.