Galindo-Pumariño Cristina, Collado Manuel, Herrera Mercedes, Peña Cristina
Medical Oncology Department, Ramón y Cajal University Hospital, IRYCIS, CIBERONC, Alcalá University, 28034 Madrid, Spain.
Department of Oncology-Pathology, Karolinska Institutet, 17164 Stockholm, Sweden.
Cancers (Basel). 2021 Mar 6;13(5):1130. doi: 10.3390/cancers13051130.
Colorectal cancer (CRC) is one of the most common cancers in western countries. Its mortality rate varies greatly, depending on the stage of the disease. The main cause of CRC mortality is metastasis, which most commonly affects the liver. The role of tumor microenvironment in tumor initiation, progression and metastasis development has been widely studied. In this review we summarize the role of the tumor microenvironment in the liver pre-metastatic niche formation, paying attention to the distant cellular crosstalk mediated by exosomes. Moreover, and based on the prognostic and predictive capacity of alterations in the stromal compartment of tumors, we describe the role of tumor microenvironment cells and related liquid biopsy biomarkers in the delivery of precise medication for metastatic CRC. Finally, we evaluate the different clinical strategies to prevent and treat liver metastatic disease, based on the targeting of the tumor microenvironment. Specifically, targeting angiogenesis pathways and regulating immune response are two important research pipelines that are being widely developed and promise great benefits.
结直肠癌（CRC）是西方国家最常见的癌症之一。其死亡率差异很大，取决于疾病的阶段。CRC死亡的主要原因是转移，最常见的转移部位是肝脏。肿瘤微环境在肿瘤起始、进展和转移发展中的作用已得到广泛研究。在本综述中，我们总结了肿瘤微环境在肝脏前转移生态位形成中的作用，关注外泌体介导的远距离细胞间通讯。此外，基于肿瘤基质区室改变的预后和预测能力，我们描述了肿瘤微环境细胞和相关液体活检生物标志物在转移性CRC精准给药中的作用。最后，我们评估了基于肿瘤微环境靶向的预防和治疗肝转移疾病的不同临床策略。具体而言，靶向血管生成途径和调节免疫反应是两个正在广泛开展且有望带来巨大益处的重要研究方向。
