Tumor-Infiltrating Lymphocytes (TILs) and Gynecological Cancers

Antitumor immune response requires the presence, activation, and stimulation of all lymphoid components of the immune system. An increasing number of studies on this topic have led to the recognizing that the accumulation of tumor-infiltrating lymphocytes (TILs) in gynecological cancer is prognostic for increased survival through activation of an advanced immune response. Cancer immunoediting, the interaction process between the immune system and tumor, represents a dynamic process, with TILs playing an important role in antitumor response. Cancer development may be constrained or promoted by the immune system in three specific steps: elimination, equilibrium, and escape. Recently, therapies that modulate the immune system have emerged as a new, effective, life-changing approach in several cancers. Combination of immunotherapy and traditional treatments has proved effective in preventing tumor development, thus improving both the prognosis and overall survival of cancer patients. Immunomodulatory therapies have already become standard of care for some cancers. Such an approach can possibly be extended also to gynecological cancers. Despite extensive knowledge in tumor diagnosis and treatment, new strategies are strongly required that while effective at attacking the disease, can also be more tolerable. This chapter is devoted to authors’ analysis of tumor response mechanisms and TILs action in gynecological malignancies, both from a molecular and a clinical perspective.