Why doctors want tumors hot. That means they’re more likely to… | by River D’Almeida, Ph.D | The Reading Frame | Jan, 2024

That means they’re more likely to respond to therapy

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Our immune system is like a highly trained security team, constantly on the lookout for cells that don’t belong — including cancer cells. Normally, it can recognize and destroy these invaders effectively.

However, some tumors are like master spies with advanced cloaking devices; they can hide from the immune system by either disguising themselves to look ‘normal’ or by sending out signals that trick the immune system into thinking they’re harmless.

In other cases, they create a hostile environment that weakens the immune cells, preventing them from functioning properly. This ability to evade the immune system is a significant hurdle in cancer treatment.

What are cold tumors?

“Cold” tumors refer to types of cancer that do not provoke a strong response from the immune system. Examples include certain forms of pancreatic cancer, glioblastoma (a type of brain tumor), and prostate cancer. These types often have fewer mutations, may not present enough abnormal signals to attract the immune system’s attention, or they might create a suppressive environment around them that deters immune activity.

Each type of ‘cold’ tumor has unique mechanisms for evading the immune system, making them more resistant to treatments that rely on immune activation.

Doctors can determine if a tumor is “cold” by using sequencing techniques to analyze the tumor’s genetic material. This allows them to look for specific markers or the presence of immune cells within the tumor. If the sequencing data shows a lack of mutations that can be recognized by the immune system, or a low presence of immune cells, especially T cells, within the tumor environment, it can be classified as “cold.”

This indicates that the tumor may be less responsive to immunotherapies that rely on the body’s natural immune response.

From hot to cold

To turn “cold” tumors “hot,” thereby making them more recognizable to the immune system, scientists are exploring several innovative strategies:

  • Immunotherapies: Treatments like checkpoint inhibitors are used to block the proteins that allow cancer cells to avoid…

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