The DOI matches its Crossref record; 69 of the 74 references it cites were found in a registry or an index.
Fibroblast Heterogeneity and Immunosuppressive Environment in Human Breast Cancer
Open accessAbstract
Carcinoma-associated fibroblasts (CAF) are key players in the tumor microenvironment. Here, we characterize four CAF subsets in breast cancer with distinct properties and levels of activation. Two myofibroblastic subsets (CAF-S1, CAF-S4) accumulate differentially in triple-negative breast cancers (TNBC). CAF-S1 fibroblasts promote an immunosuppressive environment through a multi-step mechanism. By secreting CXCL12, CAF-S1 attracts CD4+CD25+ T lymphocytes and retains them by OX40L, PD-L2, and JAM2. Moreover, CAF-S1 increases T lymphocyte survival and promotes their differentiation into CD25 High FOXP3 High, through B7H3, CD73, and DPP4. Finally, in contrast to CAF-S4, CAF-S1 enhances the regulatory T cell capacity to inhibit T effector proliferation. These data are consistent with FOXP3+ T lymphocyte accumulation in CAF-S1-enriched TNBC and show how a CAF subset contributes to immunosuppression.
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“Interestingly, CD276 (B7-H3), known to augment Tregs and inhibit T cell responses (Costa et al., 2018, Prasad et al., 2004, Suh et al., 2003), was expressed most prominently on CAFs and TSKs.”
From Multimodal Analysis of Composition and Spatial Architecture in Human Squamous Cell Carcinoma (2020) · cites this paper as Costa et al., 2018
In the citing paper
“FAP-high fibroblasts are correlated with Treg cell-mediated immunosuppression and a poor outcome119”
From A framework for advancing our understanding of cancer-associated fibroblasts (2020) · cites this paper as [119]
In the citing paper
“Clinical analysis further supports an inverse association between CAFs and CD8+ T cells119.”
From A framework for advancing our understanding of cancer-associated fibroblasts (2020) · cites this paper as [119]
In the citing paper
“Breast cancer also shows divergent CAF phenotypes, with the primary discriminating marker being FAP.”
From A framework for advancing our understanding of cancer-associated fibroblasts (2020) · cites this paper as [119]
In the citing paper
“Additionally, they can help define the immunosuppressive environment, through effects on immune cell activation and impeding infiltration of immune cells into tumors227–231.”
From TGFβ biology in cancer progression and immunotherapy (2021) · cites this paper as [227]
In the citing paper
“Stromal fibroblasts are a major source of TGF-β in the TME40,227.”
From TGFβ biology in cancer progression and immunotherapy (2021) · cites this paper as [227]
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BackgroundOncogenic KRAS Drives Lipofibrogenesis to Promote Angiogenesis and Colon Cancer Progression
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“As aforementioned, it is increasingly recognized that the intra-tumoral heterogeneity not only exists in the epithelial compartment but also the stromal compartment of the tumors, including CAFs (29, 71, 72).”
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Yue, M., Hu, S., Sun, H., Tuo, B., Jia, B., Chen, C., Wang, W., Liu, J., Liu, Y., Sun, Z., et al. (2023) · Molecular Cancer · doi:10.1186/s12943-023-01898-5 · Cited by 119
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“A correlation analysis showed that the relative proportion of MF-C1-TDO2 myofibroblasts was positively correlated with the abundance of terminally exhausted CD8+ T cells (CD8-C5), transitory exhausted CD8+ T cells (CD8-C9), resting Tregs (CD4-C2), and activated Tregs (CD4-C5) (Supplemental Figure 5B).”
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“…tissue fi broblasts convert to CAFs they morph from spindle-to stellate-shape and begin to express new surface markers, including α -smoothmuscleactin( α -SMA), platelet-derivedgrowthfactor receptor (PDGFR α / β ), vimentin, and FAP 15,67 – 69 , among which FAP is the most speci fi c 49,67 (Table 1).”
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“Single cell RNA-sequencing has revealed heterogeneity in the expression pro fi le of CAFs and shown that transcriptionally different sub-types of CAFs can play distinct pro-or anti-tumor roles in the tumor microenvironment 15,16,18,44 .”
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“Selective genetic targeting of CAFs in vivo is difficult due to the now appreciated heterogeneity of tissue and tumor fibroblasts and the non-specificity of available cre drivers (Costa et al., 2018) (Kalluri, 2016).”
BackgroundNanomedicines modulating tumor immunosuppressive cells to enhance cancer immunotherapy
Zhu, Y., Yu, X., Thamphiwatana, S., Zheng, Y., & Pang, Z. (2020) · Acta Pharmaceutica Sinica B · doi:10.1016/j.apsb.2020.08.010 · Cited by 118
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Signaling Mechanisms of Myofibroblastic Activation: Outside-in and Inside-Out
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Tumor microenvironment and immunotherapy of oral cancer
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“CAFs recruit and retain T lymphocytes in tumor tissues through different mechanisms, such as chemokines, cell adhesion molecules, inhibition of immune checkpoint activation, and CD8+ T cell exhaustion [56].”
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“Single-cell RNA-seq analyses of different mouse and human tumors highlighted the existence of at least three CAF populations (92, 94, 95).”
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Recent Advancements in Nanomedicine for ‘Cold’ Tumor Immunotherapy
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Cancer‐associated fibroblasts: Secretions, interactions, and therapy
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High-resolution 3D imaging uncovers organ-specific vascular control of tissue aging
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“A tumor mass is composed of a panel of cancer cells with sensitivity or innate resistance to a specific drug or specific therapeutic intervention [29] (Figure 2).”
BackgroundDeterminants and functions of CAFs secretome during cancer progression and therapy
Linares, J., Marín-Jiménez, J. A., Badia-Ramentol, J., & Calon, A. (2021) · Frontiers in Cell and Developmental Biology · doi:10.3389/fcell.2020.621070 · Cited by 110
“CXCL-12 and enhancing immunosuppressive T regulatory cells (Treg) capacity to block T effector cells proliferation (Costa et al., 2018).”
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Extracellular matrix remodeling in the tumor immunity
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“Furthermore, it has been observed that CAF-S1 fi broblasts possess the ability to attract and retain T lymphocytes through the utilization of speci fi c molecules, thereby facilitating their survival and promoting their differentiation into Tregs (96).”
Background3D models in the new era of immune oncology: focus on T cells, CAF and ECM
Modugno, F. D., Colosi, C., Trono, P., Antonacci, G., Ruocco, G., & Nisticò, P. (2019) · Journal of Experimental & Clinical Cancer Research · doi:10.1186/s13046-019-1086-2 · Cited by 115
“Of note, in breast cancer different subsets of CAFs have been associated with different immunosuppressive properties [45].”
Zhu, Y., Li, X., Wang, L., Hong, X., & Yang, J. (2022) · Frontiers in Endocrinology · doi:10.3389/fendo.2022.988295 · Cited by 116
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“Single-cell transcriptomics reveal NF and CAF dynamics during tumor development Recent advances in single-cell transcriptomics have highlighted CAF heterogeneity and the existence of distinct CAF subpopulations in various cancer types[28,5,29].”
BackgroundIntratumoral heterogeneity and drug resistance in cancer
Fu, Y.-C., Liang, S.-B., Luo, M., & Wang, X. (2025) · Cancer Cell International · doi:10.1186/s12935-025-03734-w · Cited by 129
“In addition, tumor-infiltrating lymphocytes (TILs) also contribute to this complexity [81] and cancer-associated fibroblasts (CAFs) [82, 83], as well as various myeloid cell populations, including tumor-associated macrophages (TAMs) and dendritic cells (DCs) [84] Also, the TME plays a key role in…”
Lee, K.-W., Yeo, S.-Y., Gong, J.-R., Koo, O.-J., Sohn, I., Lee, W. Y., Kim, H. C., Yun, S. H., Cho, Y. B., Choi, M.-A., et al. (2022) · Nature Communications · doi:10.1038/s41467-022-30484-4 · Cited by 103
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“Likewise, another recent study revealed the existence of four CAF subtypes (S1 to S4) by single-cell RNA (scRNA) analysis, each of which has distinct roles and is distributed differently across cancer subtypes ( 16 ).”
BackgroundYang, H., Sun, B., Fan, L., Ma, W., Xu, K., Hall, S. R. R., Wang, Z., Schmid, R. A., Peng, R., Marti, T. M., et al. (2022) · Theranostics · doi:10.7150/thno.69590 · Cited by 107
“We applied the four TME subtypes to the above lung cancer patient cohort receiving immunotherapy (GSE135222) and observed Theranostics 2022, Vol. 12, Issue 7 https://www.thno.org 3123 that THBS2 expression was significantly positively correlated with Angiogenesis-Fibrosis subtype (mainly derived from the CAF signature…”
BackgroundMethodResultInfluentialCancer cell niche factors secreted from cancer-associated fibroblast by loss of H3K27me3
Maeda, M., Takeshima, H., Iida, N., Hattori, N., Yamashita, S., Moro, H., Yasukawa, Y., Nishiyama, K., Hashimoto, T., Sekine, S., et al. (2019) · Gut · doi:10.1136/gutjnl-2018-317645 · Cited by 106
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Dual Relationship Between Stromal Cells and Immune Cells in the Tumor Microenvironment
Mun, J.-Y., Leem, S., Lee, J. H., & Kim, H. S. (2022) · Frontiers in Immunology · doi:10.3389/fimmu.2022.864739 · Cited by 113
“CAF subset 1 can secrete CXCL12 to attract T cells, increase the survival of CD4CD25 T cells, and promote differentiation into CD25FOXP3 Treg cells via B7H3, CD73, and DPP4 (83, 84).”
BackgroundMacDonald, W., Purcell, C., Pinho-Schwermann, M. P., Stubbs, N. M., Srinivasan, P. R., & El‐Deiry, W. S. (2025) · Cancers · doi:10.3390/cancers17030441 · Cited by 119
“For example, an analysis of cancer-associated fibroblast (CAF) subtypes in breast cancer found differential CAF marker expression depending on the specific molecular subtype of breast cancer [80].”
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“More recently, several studies reported the existence of different subtypes of CAFs with distinct functions in the TME [95,96].”
BackgroundSalemme, V., Centonze, G., Avalle, L., Natalini, D., Piccolantonio, A., Arina, P., Morellato, A., Ala, U., Taverna, D., Turco, E., et al. (2023) · Frontiers in Oncology · doi:10.3389/fonc.2023.1170264 · Cited by 106
“In BC, different subsets of CAFs have been reported to accumulate differently in distinct subtypes and exhibit specific spatial distribution, with myofibroblastic subtypes accumulating in TNBC able to confer a tumor-suppressive TME (75).”
BackgroundMacrophages and Fibroblasts, Key Players in Cancer Chemoresistance
Ireland, L., & Mielgo, A. (2018) · Frontiers in Cell and Developmental Biology · doi:10.3389/fcell.2018.00131 · Cited by 106
“Recent advances in the field of CAF research has shown that different subsets of CAF populations with different functions co-exist within tumors (Costea et al., 2013; Brechbuhl et al., 2017; Ohlund et al., 2017; Costa et al., 2018).”
Freeman, P., & Mielgo, A. (2020) · Cancers · doi:10.3390/cancers12092687 · Cited by 106
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“8f), broadly consistent with previous reports 53,54 .”
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“(63) showed that CAF with high expression of FAP was associated with increased CD25FOXP3 T lymphocytes via the modulation of B7H3, DPP4, and CD73.”
BackgroundLobular Breast Cancer: Histomorphology and Different Concepts of a Special Spectrum of Tumors
Christgen, M., Cserni, G., Floris, G., Marchiò, C., Djerroudi, L., Kreipe, H. H., Derksen, P. W. B., & Vincent‐Salomon, A. (2021) · Cancers · doi:10.3390/cancers13153695 · Cited by 108
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Fibroblast heterogeneity in solid tumors: From single cell analysis to whole-body imaging
Peltier, A., Seban, R., Buvat, I., Bidard, F., & Mechta‐Grigoriou, F. (2022) · Seminars in Cancer Biology · doi:10.1016/j.semcancer.2022.04.008 · Cited by 96
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“…have suggested that in fl ammatory cancer-associated fi broblasts (iCAFs) have relatively high expression of pyruvate carboxylase genes 13 and can regulate the TME by secreting cytokines such as CXCL12, 16,17 which was shown to be an important chemokine in recruiting Tregs in our previous results.”
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Stroma-Targeting Therapy in Pancreatic Cancer: One Coin With Two Sides?
Jiang, B., Zhou, L., Lü, J., Wang, Y., Liu, C., You, L., & Guo, J. (2020) · Frontiers in Oncology · doi:10.3389/fonc.2020.576399 · Cited by 104
“Prominently, different subtypes of CAFs that exhibit distinct characteristics and activity levels have been identified in breast cancer (88) and PDAC (89).”
BackgroundVickman, R. E., Broman, M. M., Lanman, N. A., Franco, O. E., Sudyanti, P. A. G., Ni, Y., Ji, Y., Helfand, B. T., Petkewicz, J., Paterakos, M. C., et al. (2020) · The Prostate · doi:10.1002/pros.23929 · Cited by 88
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Role of Cancer-Associated Fibroblast in Gastric Cancer Progression and Resistance to Treatments
Ham, I., Lee, D., & Hur, H. (2019) · Journal of Oncology · doi:10.1155/2019/6270784 · Cited by 94
“However, in other solid tumors such as those of the head and neck, breast, and pancreas, recent studies show that CAFs contained in one tumor were heterogeneous, presenting different gene expression patterns and a variety of functions [21, 70, 71].”
BackgroundIdentifying key questions in the ecology and evolution of cancer
Dujon, A. M., Aktipis, A., Alix‐Panabières, C., Amend, S. R., Boddy, A. M., Brown, J. S., Capp, J., DeGregori, J. V., Ewald, P. W., Gatenby, R. A., et al. (2020) · Evolutionary Applications · doi:10.1111/eva.13190 · Cited by 93
The Multifaceted Nature of Tumor Microenvironment in Breast Carcinomas
Annaratone, L., Cascardi, E., Vissio, E., Sarotto, I., Chmielik, E., Sapino, A., Berrino, E., & Marchiò, C. (2020) · Pathobiology · doi:10.1159/000507055 · Cited by 95
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“Many of them focus on the heterogeneity and corresponding biological features of different CAF clusters in cancer.(16,17,62) However, the detailed mechanism underlying how CAFs affect the TME has been a prominent topic in recent years.”
BackgroundInfluentialGut complement induced by the microbiota combats pathogens and spares commensals
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“In two separate mouse models in which collagen XI expression was absent, animals developed chondrodysplasia where the cartilage was devoid of fibrils [25].”
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Shaashua, L., Ben-Shmuel, A., Pevsner-Fischer, M., Friedman, G., Levi-Galibov, O., Nandakumar, S., Barki, D., Nevo, R., Brown, L. E., Zhang, W., et al. (2022) · Nature Communications · doi:10.1038/s41467-022-34081-3 · Cited by 79
Role of Hypoxic Stress in Regulating Tumor Immunogenicity, Resistance and Plasticity
Terry, S., Zaarour, R. F., Venkatesh, G. H., Francis, A., El‐Sayed, W., Buart, S., Bravo, P. E., Thiery, J., & Chouaïb, S. (2018) · International Journal of Molecular Sciences · doi:10.3390/ijms19103044 · Cited by 88
Key Players of the Immunosuppressive Tumor Microenvironment and Emerging Therapeutic Strategies
Park, K., Veena, M. S., & Shin, D. S. (2022) · Frontiers in Cell and Developmental Biology · doi:10.3389/fcell.2022.830208 · Cited by 91
Signaling pathways in the regulation of cancer stem cells and associated targeted therapy
Wang, M., & Wu, M. (2022) · MedComm · doi:10.1002/mco2.176 · Cited by 96
Lee, S. H., Lee, D., Choi, J., Oh, H. J., Ham, I., Ryu, D., Lee, S.-Y., Han, D.-J., Kim, S., Moon, Y., et al. (2024) · Gut · doi:10.1136/gutjnl-2024-332901 · Cited by 94
“As previously proposed, 27 28 the depletion of both CD4+ and CD8+ T cells in fibrotic GCs could be mediated by interactions between fibroblasts and other types of immune or TME cells.”
Metabolism in the Tumor Microenvironment
Lau, A. N., & Heiden, M. G. V. (2019) · Annual Review of Cancer Biology · doi:10.1146/annurev-cancerbio-030419-033333 · Cited by 92
Opzoomer, J. W., Anstee, J. E., Dean, I., Hill, E. J., Bouybayoune, I., Caron, J., Muliaditan, T., Gordon, P., Sosnowska, D., Nuamah, R. A., et al. (2021) · Science Advances · doi:10.1126/sciadv.abg9518 · Cited by 94
Dynamic Cancer Cell Heterogeneity: Diagnostic and Therapeutic Implications
Jacquemin, V., Antoine, M., Dom, G., Detours, V., Maenhaut, C., & Dumont, J. E. (2022) · Cancers · doi:10.3390/cancers14020280 · Cited by 92
“, promoting an immunosuppressive microenvironment) and localization inside the tumor [63], illustrating CAF heterogeneity and offering an explanation to their conflicting role.”
BackgroundZeng, W., Xiong, L., Wu, W., Li, S., Liu, J., Yang, L., Lao, L., Huang, P., Zhang, M., Chen, H., et al. (2022) · Oncogene · doi:10.1038/s41388-022-02540-2 · Cited by 88
“DISCUSSION CAFs are one of the most abundant stromal cells in the tumor microenvironment and have prominent roles in cancer progression, including remodeling the ECM for tumor invasion [34], providing a niche to support chemoresistance [3], secreting cytokines to promote angiogenesis [1] and inducing immunosuppression…”
BackgroundKang, J., Lee, J. H., Cha, H., An, J., Kwon, J., Lee, S., Kim, S., Baykan, M. Y., Kim, S. Y., An, D., et al. (2024) · Nature Communications · doi:10.1038/s41467-024-48310-4 · Cited by 90
Functional diversity of cancer‐associated fibroblasts in modulating drug resistance
Bu, L., Baba, H., Yasuda, T., Uchihara, T., & Ishimoto, T. (2020) · Cancer Science · doi:10.1111/cas.14578 · Cited by 85
Tumor microenvironment and immunotherapy for triple-negative breast cancer
Guo, Z., Zhu, Z., Lin, X., Wang, S., Wen, Y., Wang, L., Zhi, L., & Zhou, J. (2024) · Biomarker Research · doi:10.1186/s40364-024-00714-6 · Cited by 95
Breast Cancer Heterogeneity and Response to Novel Therapeutics
Baliu‐Piqué, M., Pandiella, A., & Ocaña, A. (2020) · Cancers · doi:10.3390/cancers12113271 · Cited by 88
The Signaling Duo CXCL12 and CXCR4: Chemokine Fuel for Breast Cancer Tumorigenesis
Zielińska, K. A., & Katanaev, V. L. (2020) · Cancers · doi:10.3390/cancers12103071 · Cited by 85
“CAFs—the most abundant cell type in the tumor microenvironment—promote angiogenesis, inflammation, chemoresistance and metastasis in contrast to normal fibroblasts, which block tumor formation [2,35].”
BackgroundInfluentialButti, R., Nimma, R., Kundu, G., Bulbule, A., Kumar, T. V. S., Gunasekaran, V. P., Kumar, D., Kumar, D., Mane, A., Gill, S. S., et al. (2021) · Oncogene · doi:10.1038/s41388-021-01663-2 · Cited by 83
Tertiary Lymphoid Structure-B Cells Narrow Regulatory T Cells Impact in Lung Cancer Patients
Germain, C., Devi-Marulkar, P., Knockaert, S., Biton, J., Kaplon, H., Letaïef, L., Goc, J., Seguin‐Givelet, A., Gossot, D., Girard, N., et al. (2021) · Frontiers in Immunology · doi:10.3389/fimmu.2021.626776 · Cited by 89
Cao, Z., Quazi, S., Arora, S., Osellame, L. D., Burvenich, I. J. G., Janes, P. W., & Scott, A. M. (2025) · Journal of Biomedical Science · doi:10.1186/s12929-024-01099-2 · Cited by 94
The gate to metastasis: key players in cancer cell intravasation
Sznurkowska, M. K., & Aceto, N. (2021) · FEBS Journal · doi:10.1111/febs.16046 · Cited by 86
Deep Learning-Based Classification for Melanoma Detection Using XceptionNet
Lu, X., & Zadeh, F. A. (2022) · Journal of Healthcare Engineering · doi:10.1155/2022/2196096 · Cited by 87
“Also, based on this organization, melanoma is the 9 most common reason for cancer death in 2019 [10].”
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Yang, Z., Tian, H., Chen, X., Li, B., Bai, G., Cai, Q., Xu, J., Guo, W., Wang, S., Peng, Y., et al. (2024) · Nature Communications · doi:10.1038/s41467-024-52977-0 · Cited by 85
“CAFs have been proved to be closely associated with the immunosuppressive functional state of Tregs 42 .”
The Complex Interaction between the Tumor Micro-Environment and Immune Checkpoints in Breast Cancer
Barriga, V., Kuol, N., Nurgali, K., & Apostolopoulos, V. (2019) · Cancers · doi:10.3390/cancers11081205 · Cited by 86
“TNBC exhibit CAF subsets, ↑CAF-S1→ ↑T Lymphocyte survival→ ↑Treg→ Ø T effector proliferation→ Immunosuppression Female BC patient cohort (Luminal, HER2 and TN subtype tissues) FC [171]”
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Metadata
- Authors
- Costa, A., Kieffer, Y., Scholer-Dahirel, A., Pelon, F., Bourachot, B., Cardon, M., Sirven, P., Magagna, I., Fuhrmann, L., Bernard, C., Bonneau, C., Kondratova, M., Kuperstein, I., Zinovyev, A., Givel, A.-M., Parrini, M.-C., Soumelis, V., Vincent-Salomon, A., & Mechta-Grigoriou, F.
- Affiliations
- Inserm (FR)
- Institut Curie (FR)
- ORCID
- Venue
- Cancer Cell
- Publisher
- Elsevier BV
- Published
- 2018-03
- Volume
- 33
- Issue
- 3
- Pages
- 463-479.e10
- ISSN
- 1535-6108 (ISSN-L)
- OpenAlex
- W2786031287
- Cited by
- 1,705
- References
- 74
- Citations by year
- 2026: 165 · 2025: 202 · 2024: 264 · 2023: 255 · 2022: 236 · 2021: 262 · 2020: 173 · 2019: 99 · 2018: 47
- FWCI
- 54.69
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Cancer Cell (publishedVersion)
- PubMed (publishedVersion)
- HAL (submittedVersion)
- Funders
- Fondation de France
- Fondation Pierre-Gilles de Gennes
- Institut National Du Cancer (INCa-DGOS-9963)
- Fondation pour la Recherche Médicale
- SiRIC-Curie program (INCa-DGOS-4654)
- Institut National de la Santé et de la Recherche Médicale
- Institut Curie
- Ligue Nationale Contre le Cancer
- ICGex (ANR-10-EQPX-03)
- Topics
- Health Sciences › Medicine › Oncology › Cancer Immunotherapy and Biomarkers
- Life Sciences › Immunology and Microbiology › Immunology › Immune cells in cancer
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › TGF-β signaling in diseases
- Keywords
- cancer-associated fibroblasts, breast cancer, triple-negative breast cancer, tumor microenvironment, immunosuppression, regulatory T cells, CXCL12, OX40L, PD-L2, JAM2, B7-H3, CD73, dipeptidyl peptidase IV, Foxp3, CD4+ T cells, T cell survival, fibroblast heterogeneity
- MeSH terms
- Breast Neoplasms, Cell Differentiation, Fibroblasts, Humans, Immune Tolerance, Lymphocyte Activation, Lymphocytes, Tumor-Infiltrating, Cell Proliferation, T-Lymphocytes, Regulatory, Forkhead Transcription Factors, Tumor Microenvironment
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