Cutaneous T cell lymphomas (CTCLs) are a heterogeneous group of non-Hodgkin lymphomas, with mycosis fungoides and Sézary syndrome being the two common subtypes. Despite the substantial improvement in early-stage diagnosis and treatments, some patients still progress to the advanced stage with an elusive underpinning mechanism. While this unsubstantiated disease mechanism coupled with diverse clinical outcomes poses challenges in disease management, emerging evidence has implicated the tumor microenvironment in the disease process, thus revealing a promising therapeutic potential of targeting the tumor microenvironment. Notably, malignant T cells can shape their microenvironment to dampen antitumor immunity, leading to Th2-dominated responses that promote tumor progression. This is largely orchestrated by alterations in cytokines expression patterns, genetic dysregulations, inhibitory effects of immune checkpoint molecules, and immunosuppressive cells. Herein, the recent insights into the determining factors in the CTCL tumor microenvironment that support their progression have been highlighted. Also, recent advances in strategies to target the CTCL tumor micromovement with the rationale of improving treatment efficacy have been discussed.
皮肤T细胞淋巴瘤（CTCL）是一组异质性的非霍奇金淋巴瘤，其中蕈样肉芽肿和Sézary综合征是两种常见亚型。尽管早期诊断和治疗已取得显著进展，但部分患者仍会进展至晚期，其潜在机制尚不明确。这种未明确的疾病机制与多样化的临床结局相结合，给疾病管理带来挑战。然而，新出现的证据表明肿瘤微环境在疾病进程中发挥重要作用，从而揭示了靶向肿瘤微环境的治疗潜力。值得注意的是，恶性T细胞能够重塑其微环境以抑制抗肿瘤免疫，导致以Th2为主的免疫反应，进而促进肿瘤进展。这一过程主要由细胞因子表达模式的改变、基因调控异常、免疫检查点分子的抑制作用以及免疫抑制细胞共同调控。本文重点综述了近年来关于CTCL肿瘤微环境中支持其进展的决定性因素的研究进展，并讨论了基于提高疗效的靶向CTCL肿瘤微环境策略的最新研究进展。
The Tumor Microenvironment as a Therapeutic Target in Cutaneous T Cell Lymphoma
肿瘤(癌症)患者之家