Leading investigators and clinicians detail the different mechanisms used by tumors to escape and impair the immune system and then spell out possible clinical strategies to prevent or reverse tumor-induced immune dysfunction. The authors review the mechanisms of immune dysfunction and evasion mechanisms in histologically diverse human tumors, focusing on tumor-induced molecular defects in T cells and antigen-presenting cells (dendritic cells and tumors), that may serve as biomarkers for patient prognosis. They discuss the means by which these immune functions may be protected or restored in order to more effectively support the process of tumor rejection in situ. Cutting-edge techniques are outlined with the capacity to monitor the strength and quality of patients' immune responses using immunocytometry, MHC-peptide tetramers combined with apoptosis assay, ELISPOT assay, and detection of MHC-TAA peptide complexes on tumor cells.

I. Basic Mechanisms of Immune Evasion.- 1 HLA Class I Antigen-Processing Machinery and HLA Class I Antigen-Derived Peptide-Complex Defects in Tumor-Cell Escape.- 2 Immune Defects in T Cells From Cancer Patients: Parallels in Infectious Diseases.- 3 Malfunction of the Dendritic Cell System in Cancer.- 4 CD4+ T-Cell-Mediated Immunity to Cancer.- 5 Immunological Ignorance in Cancer.- 6 The Role of Receptor-Mediated Apoptosis in T-Cell Dysfunction.- 7 Alterations in T-Cell Signaling Pathways and Increased Sensitivity to Apoptosis.- 8 The Role of Tumor Gangliosides in the Immune Dysfunction of Cancer.- 9 Interleukin-l0-Induced Immune Suppression in Cancer.- 10 Accentuating Tumor Immunity Through Costimulation: A Detailed Analysis of OX40 Engagement and CTLA-4 Blockade.- 11 Optimizing T-Cell Adoptive Immunotherapy to Overcome Tumor Evasion.- 12 Tumor Resistance to Apoptosis: Mechanisms of Evasion and Implications for Radiation and Chemotherapeutic Strategies.- II. Clinical Relevance of Immune Evasion.- 13 The Development and Reversal of T-Cell Tolerance in Cancer Patients Receiving Peptide-Based Vaccines.- 14 Altered Signaling in T Lymphocytes of Patients With Cancer: A Biomarker of Prognosis?.- 15 Allogeneic Hematopoietic Blood-Cell Transplantation as Immunotherapy for Metastatic Renal Cell Carcinoma.- 16 Immune Defects in Patients Suffering From Non-Hodgkin's Lymphoma.- 17 Immune Dysfunction in Classical Hodgkin's Lymphoma.- 18 Lung Cancer and Immune Dysfunction.- 19 Primary Malignant Brain Tumors: Immune Defects and Immune Evasion.