Targeting the tumour microenvironment in ovarian cancer

Eur J Cancer. 2016 Mar:56:131-143. doi: 10.1016/j.ejca.2015.12.016. Epub 2016 Feb 3.

Abstract

The study of cancer initiation, growth, and metastasis has traditionally been focused on cancer cells, and the view that they proliferate due to uncontrolled growth signalling owing to genetic derangements. However, uncontrolled growth in tumours cannot be explained solely by aberrations in cancer cells themselves. To fully understand the biological behaviour of tumours, it is essential to understand the microenvironment in which cancer cells exist, and how they manipulate the surrounding stroma to promote the malignant phenotype. Ovarian cancer is the leading cause of death from gynaecologic cancer worldwide. The majority of patients will have objective responses to standard tumour debulking surgery and platinum-taxane doublet chemotherapy, but most will experience disease recurrence and chemotherapy resistance. As such, a great deal of effort has been put forth to develop therapies that target the tumour microenvironment in ovarian cancer. Herein, we review the key components of the tumour microenvironment as they pertain to this disease, outline targeting opportunities and supporting evidence thus far, and discuss resistance to therapy.

Keywords: Ovarian cancer; Tumour microenvironment.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Review

MeSH terms

  • Angiogenesis Inhibitors / therapeutic use
  • Animals
  • Antineoplastic Agents / therapeutic use*
  • Carcinoma, Ovarian Epithelial
  • Cell Proliferation / drug effects
  • Drug Resistance, Neoplasm
  • Endothelial Cells / drug effects
  • Endothelial Cells / metabolism
  • Endothelial Cells / pathology
  • Female
  • Fibroblasts / drug effects
  • Fibroblasts / metabolism
  • Fibroblasts / pathology
  • Humans
  • Molecular Targeted Therapy*
  • Neoplasms, Glandular and Epithelial / blood supply
  • Neoplasms, Glandular and Epithelial / drug therapy*
  • Neoplasms, Glandular and Epithelial / immunology
  • Neoplasms, Glandular and Epithelial / metabolism
  • Neoplasms, Glandular and Epithelial / pathology
  • Neovascularization, Pathologic
  • Ovarian Neoplasms / blood supply
  • Ovarian Neoplasms / drug therapy*
  • Ovarian Neoplasms / immunology
  • Ovarian Neoplasms / metabolism
  • Ovarian Neoplasms / pathology
  • Signal Transduction / drug effects
  • Tumor Burden / drug effects
  • Tumor Microenvironment / drug effects*

Substances

  • Angiogenesis Inhibitors
  • Antineoplastic Agents