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Description:Included is a discussion of the various approaches used to reduce the number or function of MDSC, along with a summary of pre-clinical studies that have examined the impact of combining immunotherapy with approaches to reduce MDSC as a means to promote anti-tumor T cell immunity and decrease tumor progression. It is widely accepted that the tumor microenvironment is immunosuppressive, both inhibiting activated immune cells and activating cells with a suppressive phenotype. Collectively, these early clinical findings suggest that accumulation of MDSC levels in cancer patients contributes to tumor progression, thereby providing a target for improving immunotherapy. In patients with melanoma, multiple myeloma, prostate, and hepatocellular carcinoma, the immuosuppressive M-MDSC is a prominent population Filipazzi et al. Myeloid derived suppressor cells are induced by chronic inflammation, and several tumor-secreted factors have been implicated in MDSC induction. Interestingly, patients with radiographic evidence of disease progression had increased levels of circulating MDSC, whereas patients who responded to treatment had decreased MDSC Diaz-Montero et al.

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