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Fig. 6 | Journal for ImmunoTherapy of Cancer

Fig. 6

From: RAS status and neoadjuvant chemotherapy impact CD8+ cells and tumor HLA class I expression in liver metastatic colorectal cancer

Fig. 6

Graphical abstract: A new sequential therapeutic strategy for liver mCRC? (1) Patients with KRAS mutated are HLA class 1 low. Neoadjuvant chemotherapy like MEK inhibitors could increase HLA-I expression in the tumor core. (2) Neoadjuvant chemotherapy like oxaliplatin and anti-EGFR can induce an immune conditioning with an increase in CD8+ cells infiltrate in tumor core, invasive margin and tumor stroma, giving a clinical response. (3) Increase in CD8+ cells within the tumor subsequently induces PD-L1 expression and a loss of immune conditioning. (4) As a result, ICP anti-PD1/PD-L1 could be considered to restore an efficient cytotoxic immune response leading to a liver recovery or easiest surgery (5)

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