Metronomic Anti-Cancer Therapy: A Multimodal Therapy Governed by the Tumor Microenvironment

The concept of cancer as a systemic disease, and the therapeutic implications of this, has gained special relevance. This concept encompasses the interactions between tumor and stromal cells and their microenvironment in the complex setting of primary tumors and metastases. These factors determine c...

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Autores principales:	Raquel Muñoz, Alessandra Girotti, Denise Hileeto, Francisco Javier Arias
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	metronomic chemotherapy cancer therapy tumor microenvironment tumor vascularization bone-marrow-derived cells cancer-associated fibroblasts Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/90d94a6fe1d74519b9d793cd9095c4b7
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spelling	oai:doaj.org-article:90d94a6fe1d74519b9d793cd9095c4b72021-11-11T15:30:43ZMetronomic Anti-Cancer Therapy: A Multimodal Therapy Governed by the Tumor Microenvironment10.3390/cancers132154142072-6694https://doaj.org/article/90d94a6fe1d74519b9d793cd9095c4b72021-10-01T00:00:00Zhttps://www.mdpi.com/2072-6694/13/21/5414https://doaj.org/toc/2072-6694The concept of cancer as a systemic disease, and the therapeutic implications of this, has gained special relevance. This concept encompasses the interactions between tumor and stromal cells and their microenvironment in the complex setting of primary tumors and metastases. These factors determine cellular co-evolution in time and space, contribute to tumor progression, and could counteract therapeutic effects. Additionally, cancer therapies can induce cellular and molecular responses in the tumor and host that allow them to escape therapy and promote tumor progression. In this study, we describe the vascular network, tumor-infiltrated immune cells, and cancer-associated fibroblasts as sources of heterogeneity and plasticity in the tumor microenvironment, and their influence on cancer progression. We also discuss tumor and host responses to the chemotherapy regimen, at the maximum tolerated dose, mainly targeting cancer cells, and a multimodal metronomic chemotherapy approach targeting both cancer cells and their microenvironment. In a combination therapy context, metronomic chemotherapy exhibits antimetastatic efficacy with low toxicity but is not exempt from resistance mechanisms. As such, a better understanding of the interactions between the components of the tumor microenvironment could improve the selection of drug combinations and schedules, as well as the use of nano-therapeutic agents against certain malignancies.Raquel MuñozAlessandra GirottiDenise HileetoFrancisco Javier AriasMDPI AGarticlemetronomic chemotherapycancer therapytumor microenvironmenttumor vascularizationbone-marrow-derived cellscancer-associated fibroblastsNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENCancers, Vol 13, Iss 5414, p 5414 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	metronomic chemotherapy cancer therapy tumor microenvironment tumor vascularization bone-marrow-derived cells cancer-associated fibroblasts Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	metronomic chemotherapy cancer therapy tumor microenvironment tumor vascularization bone-marrow-derived cells cancer-associated fibroblasts Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Raquel Muñoz Alessandra Girotti Denise Hileeto Francisco Javier Arias Metronomic Anti-Cancer Therapy: A Multimodal Therapy Governed by the Tumor Microenvironment
description	The concept of cancer as a systemic disease, and the therapeutic implications of this, has gained special relevance. This concept encompasses the interactions between tumor and stromal cells and their microenvironment in the complex setting of primary tumors and metastases. These factors determine cellular co-evolution in time and space, contribute to tumor progression, and could counteract therapeutic effects. Additionally, cancer therapies can induce cellular and molecular responses in the tumor and host that allow them to escape therapy and promote tumor progression. In this study, we describe the vascular network, tumor-infiltrated immune cells, and cancer-associated fibroblasts as sources of heterogeneity and plasticity in the tumor microenvironment, and their influence on cancer progression. We also discuss tumor and host responses to the chemotherapy regimen, at the maximum tolerated dose, mainly targeting cancer cells, and a multimodal metronomic chemotherapy approach targeting both cancer cells and their microenvironment. In a combination therapy context, metronomic chemotherapy exhibits antimetastatic efficacy with low toxicity but is not exempt from resistance mechanisms. As such, a better understanding of the interactions between the components of the tumor microenvironment could improve the selection of drug combinations and schedules, as well as the use of nano-therapeutic agents against certain malignancies.
format	article
author	Raquel Muñoz Alessandra Girotti Denise Hileeto Francisco Javier Arias
author_facet	Raquel Muñoz Alessandra Girotti Denise Hileeto Francisco Javier Arias
author_sort	Raquel Muñoz
title	Metronomic Anti-Cancer Therapy: A Multimodal Therapy Governed by the Tumor Microenvironment
title_short	Metronomic Anti-Cancer Therapy: A Multimodal Therapy Governed by the Tumor Microenvironment
title_full	Metronomic Anti-Cancer Therapy: A Multimodal Therapy Governed by the Tumor Microenvironment
title_fullStr	Metronomic Anti-Cancer Therapy: A Multimodal Therapy Governed by the Tumor Microenvironment
title_full_unstemmed	Metronomic Anti-Cancer Therapy: A Multimodal Therapy Governed by the Tumor Microenvironment
title_sort	metronomic anti-cancer therapy: a multimodal therapy governed by the tumor microenvironment
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/90d94a6fe1d74519b9d793cd9095c4b7
work_keys_str_mv	AT raquelmunoz metronomicanticancertherapyamultimodaltherapygovernedbythetumormicroenvironment AT alessandragirotti metronomicanticancertherapyamultimodaltherapygovernedbythetumormicroenvironment AT denisehileeto metronomicanticancertherapyamultimodaltherapygovernedbythetumormicroenvironment AT franciscojavierarias metronomicanticancertherapyamultimodaltherapygovernedbythetumormicroenvironment
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Metronomic Anti-Cancer Therapy: A Multimodal Therapy Governed by the Tumor Microenvironment

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