Tumor microenvironment: A cancer key player to be fired
Novel precision drugs that target the tumor microenvironment are entering the battlefield against cancer.
Recent advances in the prevention and treatment of early stages of cancer have achieved significant success. However, little progress has been made in the development of new methods to fight late and invasive stages of cancer.
Targeting the epithelial tumor cells, the tumor itself, with novel and innovative drugs has rendered poor results to cure or even delay these devastating invasive cancer stages.
Broadening the scope of the battle field, revealed the overexpression of several genes and proteins in patients with pancreatic ductal adenocarcinoma, infiltrating breast adenocarcinoma, and other invasive carcinomas with a lethal prognosis. But these genes and proteins were not expressed in the epithelial tumor cells, but in the microenvironment that surounds the tumor.
This peritumoral microenvironment, the tumor stroma, is a complex, heterogeneous network of extracelular matrix and cell components – fibroblasts, endothelial cells, immune cells – which play a key role in the growth, invasion, vascularisation, metastasis, immunosuppression and drug resistance.
A novel therapeutic approach to invasive tumors is arising, based on the development of novel precision drugs aimed at targets located in the peritumoral stroma. A novel way to treat cancer, which seeks to attack not the tumor cells, but the cells that facilitate tumor invasiveness, immunosuppression and drug resistance.
Powerful and specific recombinant human proteins, monoclonal antibodies and antibody-drug conjugates, targeting endothelial cells, cancer-associated fibroblasts and the extracelular matrix are under development by pioneering biopharma companies.
Precised companion diagnostic devices are also developed and validated for the stratification of patients to be treated with the drugs under deveclopment.
We envysion a new era where cancer in general and invasive tumors in particular will be beaten with orchestrated combinations of precision drugs that target the epitelial tumor cells, to block tumor growth and drugs that target the tumor microenvironment, to block tumor invasion, angiogenesis, metastasis, immunosupression and drug resistance.