Objective:

To frame therapy-induced immunoediting as a continuum and examine its implications for cancer treatment and immune evasion.

Approach:

• Therapy-induced immunoediting continuum: The review outlines a continuum from pre-existing escape, treatment-associated immune activation, selective bottleneck, residual equilibrium, to subsequent escape.
• Mechanisms of immune evasion: It discusses how genetic alterations, therapy-resistant stem-like states, and spatial reorganization contribute to diminished tumor visibility and immune access.
• Biomarker identification: The review highlights the potential of longitudinal tissue sampling, circulating tumor DNA, and spatial or single-cell profiling to detect residual equilibrium.

Key Findings:

• Anticancer treatments can eradicate immune-visible tumor cells while selecting for immune-evasive populations.
• Therapeutic pressure can reactivate immunoediting, leading to a new cycle of tumor selection and adaptation.
• Different therapies exert distinct immune-selective pressures, impacting tumor cell populations variably.

Interpretation:

The study presents a framework for understanding how cancer therapies influence tumor evolution and immune evasion.

Limitations:

• The review does not provide empirical data but rather a conceptual framework.
• It may not account for all variables influencing tumor-immune interactions.

Conclusion:

Therapy-induced immunoediting is a complex process that can lead to immune evasion.