Figure 1.

Cancer Immunoediting. ELIMINATION: (1) Neoantigen production by transformed cells. (2) Neoantigen presentation on the surface of transformed cells, associated with HLA-I. (3) Neoantigen recognition and processing by antigen presenting cells. (4) Neoantigen presentation on the surface of antigen presenting cells, associated with HLA-II. (5) T-cell activation in the presence of co-stimulatory signals. (6) Transformed cell recognition by activated T cells and elimination. EQUILIBRIUM: (7) Transformed cells with a resistant or non-immunogenic phenotype escape elimination and proliferate, although the immune system is still able to control the tumor growth. ESCAPE: (8) Uncontrolled proliferation of cells with a resistant or a non-immunogenic phenotype, leading to tumor progression and metastasis.