A Comparative Analysis of Immune Privilege in Pregnancy and Cancer in the Context of Checkpoint Blockade Immunotherapy

The document compares the immune privilege of pregnancy and cancer, especially in the context of checkpoint blockade immunotherapy, which has been effective in treating some cancers by overcoming immune evasion. Both the placenta and tumors use similar mechanisms, like non-classical HLA molecule expression and T cell suppression, to avoid immune rejection. However, there are differences, such as distinct local and systemic immune adaptations during pregnancy. The paper suggests the potential for using checkpoint blockade in pregnant cancer patients but stresses the need for more research to ensure the placenta is not harmed. It also discusses the role of TGF-B in modulating immune responses in both cancer and pregnancy. The document calls for careful clinical trials and a registry for reporting to improve treatment in pregnant cancer patients, acknowledging funding from the University of Cambridge and Cancer Research UK, with no conflicts of interest reported.