Normalizing the Abnormal: Is Remodeling the TME the Next Frontier in Cancer Care Therapy?
DOI:
https://doi.org/10.68041/jbpt.v2i2/02Keywords:
Tumor Microenvironment, Angiogenesis, Immunotherapy, Tumor Hypoxia, Extracellular MatrixAbstract
The Tumor Microenvironment (TME) is a complicated ecosystem that consists of cancer cells, stromal components, immune infiltrates, and vascular networks, which determine tumor progression, metastasis, and resistance to treatment. Historically, the treatment of cancer has been aimed directly at malignant cells without considering the contribution of the deviant microenvironment that provides sustenance to the tumors. Recent observations have highlighted that by reprogramming or re-establishing vascular integrity, immune cell homeostasis, and metabolic and stromal signaling, the TME can be reconfigured to become tumor restraining. Different therapeutic approaches that are aimed at aberrant angiogenesis, hypoxia, immune suppression, and extracellular matrix (ECM) remodeling have shown synergistic effects in association with chemotherapy or immunotherapy. There is, however, an intrinsic heterogeneity and dynamic adaptation of the TME, which is a major issue in clinical translation. The present review brings into the limelight the recent concept of TME normalization as a paradigm shift in therapy, which offers a pathway to sustainable and complete cancer management.
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