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Challenges in NK cell cancer immunotherapy. In the tumor microenvironment, cancer cells secrete anti-immune molecules TGF- β, PGE2, and indoleamine 2,3-dioxygenase (IDO) to evade NK-cell-mediated tumor-cell lysis. Vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), and adenosine inhibit NK cells from homing to tumors resulting inadequate NK cell infiltration in tumors. Tumor cells express NK cell immune checkpoint molecules to escape from NK cells.
