Mechanisms of immunogenicity in colorectal cancer

Research output: Contribution to journalReview articlepeer-review

External organisations

  • Institute of Immunology & Immunotherapy; College of Medical and Dental Sciences; University of Birmingham; Birmingham UK
  • Cancer Bioinfomatics Group, Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
  • Academic Department of Surgery, Queen Elizabeth Hospital, Edgbaston, Birmingham UK; College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.


BACKGROUND: The immune response in cancer is increasingly understood to be important in determining clinical outcomes, including responses to cancer therapies. New insights into the mechanisms underpinning the immune microenvironment in colorectal cancer are helping to develop the role of immunotherapy and suggest targeted approaches to the management of colorectal cancer at all disease stages.

METHOD: A literature search was performed in PubMed, MEDLINE and Cochrane Library databases to identify relevant articles. This narrative review discusses the current understanding of the contributors to immunogenicity in colorectal cancer and potential applications for targeted therapies.

RESULTS: Responsiveness to immunotherapy in colorectal cancer is non-uniform. Several factors, both germline and tumour-related, are potential determinants of immunogenicity in colorectal cancer. Current approaches target tumours with high immunogenicity driven by mutations in DNA mismatch repair genes. Recent work suggests a role for therapies that boost the immune response in tumours with low immunogenicity.

CONCLUSION: With the development of promising therapies to boost the innate immune response, there is significant potential for the expansion of the role of immunotherapy as an adjuvant to surgical treatment in colorectal cancer.

Bibliographic note

© 2019 The Authors. BJS published by John Wiley & Sons Ltd on behalf of BJS Society Ltd.


Original languageEnglish
Pages (from-to)1283-1297
Number of pages15
JournalBritish Journal of Surgery
Issue number10
Early online date19 Jun 2019
Publication statusPublished - Sep 2019

ASJC Scopus subject areas