Introduction

This chapter provides an introduction to the central concept of immunoediting. This fundamental process has three parts—immunosurveillance, immuneequilibrium, and immune escapewhich leads to control, stasis, or outgrowth of a malignancy. Immunoediting starts with the immune recognition and destruction of cells that have acquired the genetic and epigenetic alterations characteristic of the tumor cells, but at the same time, the selective pressure produced by immunoediting drives tumor evolution and progression. In this process, the cell intrinsic traits of cancer lead to the development of subclinical or occult lesions that are not clinically important until the cell-extrinsic traits have been achieved. The complex roles for inflammatory cells and altered immunity in the development of cell-extrinsic traits represent an increasingly important area for investigation. The chapter concludes by discussing several key aspects of immunosurveillance—the generation of innate and adaptive immune responses to the tumor cells, and the new classes of small molecule drugs termed as the molecular targeted therapeutics.