Department of Pathology and Laboratory Medicine, Boston University School of Medicine, 670 Albany Street, Boston, MA 02118, USA.
Cells. 2020 Mar 20;9(3):762. doi: 10.3390/cells9030762.
Metastasis is the primary cause of cancer-related mortality. Cancer cells primarily metastasize via blood and lymphatic vessels to colonize lymph nodes and distant organs, leading to worse prognosis. Thus, strategies to limit blood and lymphatic spread of cancer have been a focal point of cancer research for several decades. Resistance to FDA-approved anti-angiogenic therapies designed to limit blood vessel growth has emerged as a significant clinical challenge. However, there are no FDA-approved drugs that target tumor lymphangiogenesis, despite the consequences of metastasis through the lymphatic system. This review highlights several of the key resistance mechanisms to anti-angiogenic therapy and potential challenges facing anti-lymphangiogenic therapy. Blood and lymphatic vessels are more than just conduits for nutrient, fluid, and cancer cell transport. Recent studies have elucidated how these vasculatures often regulate immune responses. Vessels that are abnormal or compromised by tumor cells can lead to immunosuppression. Therapies designed to improve lymphatic vessel function while limiting metastasis may represent a viable approach to enhance immunotherapy and limit cancer progression.
转移是癌症相关死亡的主要原因。癌细胞主要通过血液和淋巴管转移到淋巴结和远处器官，从而导致预后更差。因此，几十年来，限制癌症血液和淋巴扩散的策略一直是癌症研究的重点。对旨在限制血管生长的 FDA 批准的抗血管生成疗法的耐药性已成为一个重大的临床挑战。然而，尽管转移通过淋巴系统会产生后果，但仍没有 FDA 批准的药物可以针对肿瘤淋巴管生成。这篇综述强调了几种抗血管生成治疗的主要耐药机制，以及抗淋巴管生成治疗面临的潜在挑战。血液和淋巴管不仅仅是营养物质、液体和癌细胞运输的通道。最近的研究阐明了这些脉管系统如何经常调节免疫反应。肿瘤细胞异常或受损的血管会导致免疫抑制。旨在改善淋巴管功能同时限制转移的治疗方法可能代表一种可行的方法，可增强免疫疗法并限制癌症进展。
