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This article is part of the supplement: Proceedings of the 2012 Sino-American Symposium on Clinical and Translational Medicine (SAS-CTM)

Open Access Open Badges Meeting abstract

The challenge of studying complex diseases undergoing complex treatments: the metastatic cancer model

Ena Wang and Francesco M Marincola*

Author Affiliations

Infectious Disease and Immunogenetics Section (IDIS), Department of Transfusion Medicine, Clinical Center and trans-NIH Center for Human Immunology (CHI), National Institutes of Health, Bethesda, Maryland, USA

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Journal of Translational Medicine 2012, 10(Suppl 2):A46  doi:10.1186/1479-5876-10-S2-A46

The electronic version of this article is the complete one and can be found online at:

Published:17 October 2012

© 2012 Wang and Marincola; licensee BioMed Central Ltd.

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Meeting abstract

A cancer immune signature implicating good prognosis and responsiveness to immunotherapy was described that is observed also in other aspects of immune-mediated, tissue-specific destruction (TSD) [1,2]. Its determinism remains, however, elusive. On one side it appears that the genetic background of the host’s bears significantly on immune responsiveness, on the other it appears that tumor can behave differently within the same genetic background (as in the case of mixed responses). This apparent paradox can only be explained by a multi-factorial model of cancer immune responsiveness [3]. It should be emphasized that host and cancer genetics are largely overlapping since cancer cells carry the majority of the host’s genetics. Thus, inherited genetic factors may affect the biology of cancer cells besides that of normal cells. It could be postulated that some patients carry a genetic background that make them resistant to immunotherapy by effecting either the biology of the immune response, the biology of the cancer cells or both. On the other hand, “an immune-responsive genotype” may still be limited by the genetics of the tumors: in other words, although the patient may be predisposed to cancer rejection the tumor lacks additional properties necessary for its recognition by the immune response [4]. In this model, a favorable genetic background of the host is necessary but not sufficient for tumor rejection as the possession of a shotgun is necessary to shoot a duck but at the same time a skill in shooting is required. A good example is provided by the analysis of patients with IRF-5 polymorphism [5]; the “immune resistant phenotype” appears to almost exclusively preclude cancer rejection during adoptive therapy with tumor infiltrating lymphocytes; however, “the immune responsive phenotype” can be segregated into two categories; one enriched in patients responding to therapy and the other of non-responding [6,7]. Although, other host’s genetic factors could be responsible for this sub-classification, it is also possible that, given a favorable genetic background, the genetics of the tumor may become the determining factor [8].

We recognize that this classification of factors that may influence immune responsiveness may be too rigid. In reality, immune responsiveness may depend upon a continuum determined by the interaction of a multitude of factors that for simplicity can be separated into broad categories depending upon the host’s genetic background, somatic mutations, and external factors such as intensity and effectiveness of treatment, general condition of the patient and a multitude of other hidden co-factors. In the presentation at the NY Academy of Sciences we will present our strategy to dissect the question of cancer immune responsiveness by study dynamically the behavior of human cancers under natural conditions on in response to therapy.


  1. Wang E, Worschech A, Marincola FM: The immunologic constant of rejection.

    Trends Immunol 2008, 29:256-262. PubMed Abstract | Publisher Full Text OpenURL

  2. Immunologic signatures of rejection Springer. New York, NY; 2010.

  3. Wang E, Marincola FM: Bottom up: a modular view of immunology.

    Immunity 2008, 29:9-11. PubMed Abstract | Publisher Full Text | PubMed Central Full Text OpenURL

  4. Wang E, Uccellini L, Marincola FM: A genetic inference on cancer immune responsiveness.

    Oncoimmunology 2012, in press. OpenURL

  5. Uccellini L, Erdenebileg N, De Giorgi V, Tomei S, Ascierto ML, Bedognetti D, Liu Q, Wang E, Marincola FM, Rosenberg SA: IRF-5 gene polymorphism and melanoma.


    in preparation

  6. Wang E, Marincola FM: A natural history of melanoma: serial gene expression analysis.

    Immunol Today 2000, 21:619-623. PubMed Abstract | Publisher Full Text OpenURL

  7. Wang E, Miller LD, Ohnmacht GA, Mocellin S, Petersen D, Zhao Y, Simon R, Powell JI, Asaki E, Alexander HR, et al.: Prospective molecular profiling of subcutaneous melanoma metastases suggests classifiers of immune responsiveness.

    Cancer Res 2002, 62:3581-3586. PubMed Abstract | Publisher Full Text | PubMed Central Full Text OpenURL

  8. Ascierto ML, De Giorgi V, Liu Q, Bedognetti D, Murtas D, Chouchane L, Wang E, Marincola FM: An immunologic portrait of cancer.

    J Transl Med 2011, 9:146. PubMed Abstract | BioMed Central Full Text | PubMed Central Full Text OpenURL