Tumor tissue architecture, immune cells and molecular characteristics in relation to immune escape in colon cancer: what rises must fall

Zhu, H. (2026)

Doctoral Thesis

This thesis explores the complex mechanisms of immune escape in colon cancer, focusing on the dynamic interactions between tumor tissue architecture, immune cell populations, and molecular characteristics. By investigating the tumor microenvironment (TME), this research elucidates how colon tumors successfully evade immune surveillance. Key findings demonstrate the spatial distribution and functional states of immune cells, highlighting their prognostic value when combined with specific molecular profiles. The subtitle, "What Rises Must Fall," reflects the evolutionary trajectory of the tumor-immune interaction, where initially robust immune responses are eventually suppressed or exhausted. Ultimately, this work provides profound insights into colon cancer pathogenesis and identifies potential biomarkers, paving the way for more effective, targeted immunotherapies and personalized patient care.

• Colon cancer
• Immune escape
• Tumor microenvironment
• Immune cells
• Molecular characteristics
• Biomarkers
• Tumor-infiltrating lymphocytes

• All authors: Zhu, H.
• Supervisor: Tollenaar, R.A.E.M.; Kuppen, P.J.K.; Roelands, J.
• Committee: Vahrmeijer, A.L.; Gruijl, T.D. de; Egmond, M. van; Sluis, T.C. van der
• Qualification: Doctor (dr.)
• Awarding Institution: Faculty of Medicine, Leiden University Medical Center (LUMC), Leiden University
• Date: 2026-07-09
• DOI: doi:10.60602/1887-4307839