CEDOC, Chronic Diseases Research Centre, NOVA Medical School | Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, Lisbon, Portugal.
Instituto Português de Oncologia de Lisboa Francisco Gentil (IPOLFG), Lisbon, Portugal.
Adv Exp Med Biol. 2020;1219:35-49. doi: 10.1007/978-3-030-34025-4_2.
In 2018, 9.6 million deaths from cancer were estimated, being this disease the second leading cause of death worldwide. Notwithstanding all the efforts developed in prevention, diagnosis and new treatment approaches, chemoresistance seems to be inevitable, leading to cancer progression, recurrence and affecting the outcome of the disease. As more and more evidence support that cancer is an evolutionary and ecological process, this concept is rarely applied in the clinical context. In fact, cancer cells emerge and progress within an ecological niche - the tumor microenvironment - that is shared with several other cell types and that is continuously changing. Therefore, the tumor microenvironment imposes several selective pressures on cancer cells such as acidosis, hypoxia, competition for space and resources, immune predation and anti-cancer therapies, that cancer cells must be able to adapt to or will face extinction.In here, the role of the tumor microenvironment selective pressures on cancer progression will be discussed, as well as the targeting of its features/components as strategies to fight cancer.
2018 年，癌症死亡人数估计为 960 万，是全球第二大死亡原因。尽管在预防、诊断和新的治疗方法方面做出了所有努力，但化学耐药性似乎不可避免，导致癌症进展、复发并影响疾病的结果。随着越来越多的证据支持癌症是一个进化和生态过程的概念，这一概念很少在临床环境中应用。事实上，癌细胞在一个生态位——肿瘤微环境——中出现并进展，这个生态位与其他几种细胞类型共享，并不断变化。因此，肿瘤微环境对癌细胞施加了几种选择性压力，如酸中毒、缺氧、空间和资源竞争、免疫捕食和抗癌治疗，癌细胞必须能够适应这些压力，否则将面临灭绝。在这里，将讨论肿瘤微环境对癌症进展的选择性压力的作用，以及针对其特征/成分作为抗癌策略的作用。
