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The following is a summary of “Seizing the fate of lymph nodes in immunotherapy: To preserve or not?,” published in the February 2024 issue of Oncology by Xu et al.
Lymph node dissection, historically integral to cancer management, is undergoing reevaluation due to ongoing debates surrounding its efficacy and potential complications. Concurrently, immunotherapy has transformed cancer treatment paradigms, albeit with variable patient responses. Notably, emerging evidence highlights the critical role of lymph nodes in orchestrating immune responses to cancer, implicating their preservation as vital for optimizing treatment outcomes. Against this backdrop, the focus is twofold: to elucidate the intricate mechanisms governing immune activation within lymph nodes and to provide a comprehensive overview of evolving strategies for lymph node management in the era of immunotherapy.
Understanding the mechanisms of immune activation within lymph nodes is pivotal. Lymph nodes serve as hubs for immune cell interaction and priming, facilitating the generation of robust antitumor immune responses. Thus, preserving lymph nodes may enhance the efficacy of immunotherapy by maintaining these crucial immunological processes. Simultaneously, advances in diagnostic modalities enable minimally invasive assessment of lymph node metastasis, facilitating more precise treatment decisions.
Moreover, current strategies aim to harness the potential of lymph nodes to amplify immunotherapeutic responses. These include neoadjuvant immunotherapy approaches designed to prime the immune system before surgery, capitalizing on the lymphatic system’s inherent role in immune surveillance and activation. However, the decision to forego lymph node dissection poses challenges, as it may impact prognostic outcomes and necessitates careful consideration of individual patient factors.
Achieving comprehensive cancer treatment may entail a paradigm shift towards prioritizing lymph node preservation in immunotherapy-driven approaches. Yet, significant hurdles remain, including refining patient selection criteria and optimizing therapeutic regimens to maximize the benefits of lymph node-sparing strategies. Addressing these challenges will be pivotal in realizing the full potential of lymph node preservation as a cornerstone of modern cancer care.
Source: sciencedirect.com/science/article/abs/pii/S0304383524001332