Mpekris Fotios, Panagi Myrofora, Charalambous Antonia, Voutouri Chrysovalantis, Stylianopoulos Triantafyllos
Cancer Biophysics Laboratory, Department of Mechanical and Manufacturing Engineering, University of Cyprus, Nicosia, Cyprus.
Cancer Biophysics Laboratory, Department of Mechanical and Manufacturing Engineering, University of Cyprus, Nicosia, Cyprus.
Cell Rep Med. 2024 Jul 16;5(7):101626. doi: 10.1016/j.xcrm.2024.101626. Epub 2024 Jun 28.
Solid tumor pathology, characterized by abnormalities in the tumor microenvironment (TME), challenges therapeutic effectiveness. Mechanical factors, including increased tumor stiffness and accumulation of intratumoral forces, can determine the success of cancer treatments, defining the tumor's "mechanopathology" profile. These abnormalities cause extensive vascular compression, leading to hypoperfusion and hypoxia. Hypoperfusion hinders drug delivery, while hypoxia creates an unfavorable TME, promoting tumor progression through immunosuppression, heightened metastatic potential, drug resistance, and chaotic angiogenesis. Strategies targeting TME mechanopathology, such as vascular and stroma normalization, hold promise in enhancing cancer therapies with some already advancing to the clinic. Normalization can be achieved using anti-angiogenic agents, mechanotherapeutics, immune checkpoint inhibitors, engineered bacterial therapeutics, metronomic nanomedicine, and ultrasound sonopermeation. Here, we review the methods developed to rectify tumor mechanopathology, which have even led to cures in preclinical models, and discuss their bench-to-bedside translation, including the derivation of biomarkers from tumor mechanopathology for personalized therapy.
实体瘤病理学以肿瘤微环境(TME)异常为特征,对治疗效果构成挑战。机械因素,包括肿瘤硬度增加和肿瘤内压力积聚,可决定癌症治疗的成败,从而确定肿瘤的“机械病理学”特征。这些异常会导致广泛的血管受压,进而导致灌注不足和缺氧。灌注不足会阻碍药物递送,而缺氧会产生不利的肿瘤微环境,通过免疫抑制、增强转移潜能、耐药性和紊乱的血管生成促进肿瘤进展。针对肿瘤微环境机械病理学的策略,如血管和基质正常化,有望增强癌症治疗效果,其中一些策略已进入临床阶段。使用抗血管生成药物、机械疗法、免疫检查点抑制剂、工程细菌疗法、小剂量纳米药物和超声透入等方法可实现正常化。在此,我们回顾了为纠正肿瘤机械病理学而开发的方法,这些方法甚至在临床前模型中实现了治愈,并讨论了它们从 bench 到 bedside 的转化,包括从肿瘤机械病理学中衍生生物标志物用于个性化治疗。
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