Cancer and immune suppression: from epidemiology to therapeutic challenges

Innate or acquired immune suppression, especially in transplanted or in HIV-infected population, is related to an increased risk of cancers associated with significant morbidity and death. The epidemiology and the clinical presentation varies between immunocompromised and nonimmunocompromised population, with a major impact of infectious agents in oncogenesis, and often with a more advanced stage at diagnosis, a more aggressive pathology, and associated morbidities like immunosuppression leading to poorer outcomes. Specific guidelines are missing and practitioners should take into account comorbidities and potential drug interactions, particularly through the cytochrome P450, requiring the use of a multidisciplinary approach, such as the CANCERVIH group in France. The aim of this review is to present a scientific update of immunosuppression-associated malignancies in their clinical aspect, and their specific therapeutic management.