A disruptive concept : the Tumoral Stroma Immunomodulation
- The Tumoral Stroma has been identified as a key player in the initiation and progression of many solid cancers
- The Tumoral Stroma is a very complex structure, composed of the Extra-Cellular Matrix (ECM), fibroblasts and cells of the immune system, irrigated by blood and lymph node vessels
- The Tumoral Stroma is a natural wounding reaction of the body against the tumor; however, the tumor can turnround this wounding reaction and use the tumoral stroma to its own benefit :
Stroma acts as a physical and functional barrier preventing access of the immune system cells (particularly CD8+ T cells) and therapeutic agents to the primary tumor site, thus promoting tumor growth and reducing drug efficacy.
Re-organized collagen in the tumoral stroma confers metastatic properties to tumor cells.
Stroma increases micro-environment complexity, making surgery very difficult.
- Modulating the stroma allows to mitigate its tumor promoting role and facilitate delivery of the therapeutic agents at the core of the tumor.
Fernandes M, Rosel D, Brábek J. Translation in solid cancer: are size-based response criteria an anachronism?. Clin Transl Oncol. 2015;17(1):1-10.