NTTS 2017

Primary cancer grows within the stromal cells which constitute the tumor microenvironment consisting of normal cells such as fibroblasts, lipocytes, immune cells, lymphatic and vascular vessels and other parenchymal cells. Cancer development is associated with uncontrolled proliferation, suppression of apoptosis, stabilization of telomeres, increase in mutation rates, evasion of the immune system, induction of lymphangiogenesis and acquisition of metastatic properties. Each of these characteristics is genetically dependent. Similar to Darwin’s theory of evolution, the tumor microenvironment exerts either a positive or negative force for tumor growth, thus, acting like a natural selection over the genetic diversity of the tumor population. The greater the genetic diversity within the tumor, the more likely it is for the emergence of the fittest clones being selected by the tumor microenvironment. Using techniques such as multiplexed microscopy, DNA/mRNA profiling, microRNA analysis and gene exon sequencing, we are learning more and more about this intricate relationship between tumor microenvironment and the emergence of more aggressive metastatic clones to systemic sites via the lymphatic and vascular vessels. Understanding such intricate molecular mechanisms, rational therapy may be directed to control or block the process of metastasis.