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Published on: November 7, 2015
The role of tumor microenvironment in melanoma therapy resistance
Rajasekharan Somasundaram1,1, Meenhard Herlyn1,1, Stephan N Wagner2,2
1The Wistar Institute, 3601 Spruce St, Philadelphia, PA 19104, USA.
Abstract:
Melanoma patients develop resistance to both chemotherapy and targeted-therapy drugs. Promising preclinical and clinical results with immune checkpoint inhibitors using antibodies directed against cytotoxic T-lymphocyte-associated protein 4 and programmed cell death protein 1 have re-energized the field of immune-based therapies in melanoma. However, similar to chemotherapy or targeted therapies, immune checkpoint blockade responds in only subsets of melanoma patients. A number of factors, including gene mutations, altered cell-signaling pathways and tumor heterogeneity can contribute to therapy resistance. Recent studies have highlighted the role of inflammatory tumor microenvironment on therapy resistance of cancer cells. Cancer cells either alone or in conjunction with the tumor stroma can contribute to an inflammatory microenvironment. Multimodal approaches of targeting the tumor microenvironment, in addition to malignant cells, may be necessary for better therapy responses.
Insights
Melanoma patients often resist treatments. Targeting the tumor microenvironment alongside cancer cells may improve responses to therapies like immune checkpoint inhibitors.
Area of Science:
- Oncology
- Immunology
- Cancer Biology
Background:
- Melanoma patients exhibit resistance to conventional chemotherapy and targeted therapies.
- Immune checkpoint inhibitors targeting cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) and programmed cell death protein 1 (PD-1) show promise but benefit only a subset of patients.
- Therapy resistance in melanoma is multifactorial, involving genetic mutations, signaling pathways, and tumor heterogeneity.
Purpose of the Study:
- To explore the role of the tumor microenvironment in melanoma therapy resistance.
- To investigate the potential of multimodal therapeutic strategies targeting both cancer cells and the tumor microenvironment.
Main Methods:
- Review of preclinical and clinical studies on melanoma treatment resistance.
- Analysis of factors contributing to resistance, including tumor microenvironment characteristics.
- Evaluation of immune checkpoint inhibitor efficacy and limitations.
Main Results:
- The tumor microenvironment, influenced by cancer cells and stroma, plays a significant role in mediating resistance to melanoma therapies.
- Inflammatory signals within the tumor microenvironment can promote cancer cell survival and treatment evasion.
- Current therapies, including immune checkpoint blockade, face limitations due to intrinsic or acquired resistance mechanisms.
Conclusions:
- Multimodal therapeutic approaches are essential for overcoming melanoma therapy resistance.
- Targeting the tumor microenvironment in conjunction with direct anti-cancer therapies may enhance treatment efficacy.
- Further research into the interplay between cancer cells and their microenvironment is crucial for developing more effective melanoma treatments.
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