Published online Feb 24, 2023. doi: 10.5306/wjco.v14.i2.81
Peer-review started: September 20, 2022
First decision: November 28, 2022
Revised: December 13, 2022
Accepted: February 7, 2023
Article in press: February 7, 2023
Published online: February 24, 2023
Processing time: 153 Days and 18.2 Hours
Cold colorectal tumors are not likely to trigger a robust immune response and tend to suppress the immune response. There may be three reasons. First, the complex tumor microenvironment of cold colorectal cancer (CRC) leads to tolerance and clearance of immunotherapy. Second, the modification and concealment of tumor-specific targets in cold CRC cause immune escape and immune response interruption. Finally, the difference in number and function of immune cell subsets in patients with cold CRC makes them respond poorly to immunotherapy. Therefore, we can only overcome the challenges in immunotherapy of cold CRC through in-depth research and understanding the changes and mechanisms in the above three aspects of cold CRC.
Core Tip: Advanced colorectal tumors are poorly treated, and immunotherapy has improved these patients’ outcomes. However, cold colorectal tumors are less likely to trigger a robust immune response and tend to suppress it. To address this phenomenon, we discuss the role of the tumor microenvironment, immune targets, and immune cells in the treatment of cold colorectal tumors.