Targeting Tumor Microenvironment for Cancer Therapy.
Catarina Roma-RodriguesRita MendesPedro Viana BaptistaAlexandra Ramos FernandesPublished in: International journal of molecular sciences (2019)
Cancer development is highly associated to the physiological state of the tumor microenvironment (TME). Despite the existing heterogeneity of tumors from the same or from different anatomical locations, common features can be found in the TME maturation of epithelial-derived tumors. Genetic alterations in tumor cells result in hyperplasia, uncontrolled growth, resistance to apoptosis, and metabolic shift towards anaerobic glycolysis (Warburg effect). These events create hypoxia, oxidative stress and acidosis within the TME triggering an adjustment of the extracellular matrix (ECM), a response from neighbor stromal cells (e.g., fibroblasts) and immune cells (lymphocytes and macrophages), inducing angiogenesis and, ultimately, resulting in metastasis. Exosomes secreted by TME cells are central players in all these events. The TME profile is preponderant on prognosis and impacts efficacy of anti-cancer therapies. Hence, a big effort has been made to develop new therapeutic strategies towards a more efficient targeting of TME. These efforts focus on: (i) therapeutic strategies targeting TME components, extending from conventional therapeutics, to combined therapies and nanomedicines; and (ii) the development of models that accurately resemble the TME for bench investigations, including tumor-tissue explants, "tumor on a chip" or multicellular tumor-spheroids.
Keyphrases
- cancer therapy
- extracellular matrix
- oxidative stress
- induced apoptosis
- cell cycle arrest
- drug delivery
- endothelial cells
- endoplasmic reticulum stress
- mesenchymal stem cells
- stem cells
- small molecule
- cell proliferation
- gene expression
- vascular endothelial growth factor
- quality improvement
- young adults
- single cell
- heat shock
- bone marrow
- big data
- genome wide
- sewage sludge