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Graphical representation of the mechanisms of immune evasion by cancer stem cells (CSCs). CSCs promote an immunosuppressive microenvironment via direct interaction with T cells (A,B), genetic regulation leading to reduced immunogenicity (C) and paracrine mechanisms provoking immune cells anergy and suppression of the immune response (D). MDSC, Myeloid-derived suppressor cells; TME, tumor microenvironment.
