The tumor microenvironment: a key player in multidrug resistance in cancer

IF 1.4 4区 医学 Q4 ONCOLOGY
Lingnan Meng, Ying Zheng, Hao Liu, Daiming Fan
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Abstract

Abstract Cancer is the second leading cause of death worldwide. Although multiple new cancer treatments have emerged in recent years, drug therapy, mainly comprising chemotherapy, targeted therapy, and immunotherapy, remains the most common approach. The multidrug resistance (MDR) of cancer cells to various treatments remains a challenge. Scientists have always focused on the acquired drug resistance mechanisms of tumor cells themselves. However, recent evidence shows that the tumor microenvironment (TME) plays a critical role in regulating tumor cell progression, metastasis, immune escape, and drug resistance. In the TME, interactions between cancer cells and non-malignant cells often modify the TME and facilitate drug resistance. Therefore, elucidating this complex interaction mechanism is essential for the development of effective treatments. This review focuses on the role of the TME in promoting chemoresistance in tumor cells through the following mechanisms: (i) inhibiting the immune clearance of tumor cells and facilitating immune escape responses; (ii) stimulating the release of soluble paracrine factors to enhance tumor survival and growth; (iii) promoting survival and altering drug delivery through metabolic reprogramming; (iv) obstructing drug absorption by inducing changes in stomatal cells and blood vessels surrounding the tumor; and (v) inducing the cancer stem cell phenotype. This review also addresses a clinical treatment strategy for targeting the TME, providing insights and a basis for reversing multidrug resistance.
肿瘤微环境:癌症多药耐药性的关键因素
摘要 癌症是全球第二大死因。尽管近年来出现了多种新的癌症治疗方法,但药物治疗(主要包括化疗、靶向治疗和免疫治疗)仍是最常用的方法。癌细胞对各种疗法的多药耐药性(MDR)仍然是一个挑战。科学家们一直关注肿瘤细胞本身的获得性耐药机制。然而,最近的证据表明,肿瘤微环境(TME)在调控肿瘤细胞进展、转移、免疫逃逸和耐药性方面起着至关重要的作用。在肿瘤微环境中,癌细胞与非恶性细胞之间的相互作用往往会改变肿瘤微环境并促进耐药性的产生。因此,阐明这种复杂的相互作用机制对于开发有效的治疗方法至关重要。本综述重点探讨TME通过以下机制促进肿瘤细胞产生化疗耐药性的作用:(i) 抑制肿瘤细胞的免疫清除,促进免疫逃逸反应;(ii) 刺激可溶性旁分泌因子的释放,增强肿瘤的生存和生长;(iii) 通过代谢重编程促进生存和改变药物输送;(iv) 通过诱导肿瘤周围气孔细胞和血管的变化阻碍药物吸收;(v) 诱导癌症干细胞表型。本综述还探讨了针对TME的临床治疗策略,为逆转多药耐药性提供了见解和依据。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Oncologie
Oncologie 医学-肿瘤学
CiteScore
1.30
自引率
11.10%
发文量
32
审稿时长
6-12 weeks
期刊介绍: Oncologie is aimed to the publication of high quality original research articles, review papers, case report, etc. with an active interest in vivo or vitro study of cancer biology. Study relating to the pathology, diagnosis, and advanced treatment of all types of cancers, as well as research from any of the disciplines related to this field of interest. The journal has English and French bilingual publication.
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