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New Advancement in Tumor Microenvironment Remodeling and Cancer Therapy
Tumor microenvironment (TME) refers to the area with non-malignant cells, signaling molecules and blood vessels that surrounds and feeds tumor cells. A tumor can change its microenvironment, and TME is also known to profoundly impact the occurrence, growth, metastasis and therapeutic response and resistance of tumors. The special paracrine characteristics, microvascular system, extracellular matrix components and stromal cells in TME promote local tumor immune suppression and could alter the penetration and distribution of drugs into tumor tissues. Accumulating evidence demonstrates that currently available tumor therapies (i.e., chemotherapy, radiotherapy, anti-vascular therapy, small molecule targeted therapy, immune checkpoint inhibitors) also in turn greatly affect the structure, function, and physical and chemical properties of TME, leading to TME remodeling. However, whether and how interaction of tumor cells and TME modeling can be dissected and targeted to further understand the underlying molecular mechanisms and establish effective new tumor therapies remains elusive.
Novel Agents for Multiple Myeloma
Multiple myeloma (MM) is a malignant neoplasm of plasma cells that accumulate in bone marrow, leading to bone destruction and marrow failure. It accounts for approximately 1.8% of all hematologic and solid cancers and slightly > 15% of hematologic malignancies in the United States. MM is typically sensitive to different classes of cytotoxic drugs, both as frontline treatment and as treatment for relapsed disease. Unfortunately, even if responses are typically durable, nowadays MM is not considered curable with current approaches. However, MM survival rates have been brilliantly improved thanks to the introduction of novel agents: patients diagnosed after 2010 have had higher rates of novel therapy use and better survival outcomes compared with those of earlier years. Most relevant therapeutic advances over the past decades has been the introduction of novel therapies, such as immune-modifying agents (thalidomide and lenalidomide) and proteasome inhibitors (bortezomib), adopted with or without stem cell transplantation.
