Abstract
Objective: This review describes the comprehensive portrait of tumor microenvironment (TME). Additionally, we provided a panoramic perspective on the transformation and functions of the diverse constituents in TME, and the underlying mechanisms of drug resistance, beginning with the immune cells and metabolic dynamics within TME. Lastly, we summarized the most auspicious potential therapeutic strategies.
Results: TME is a unique realm crafted by malignant cells to withstand the onslaught of endogenous and exogenous therapies. Recent research has revealed many small-molecule immunotherapies exhibiting auspicious outcomes in preclinical investigations. Furthermore, some pro-immune mechanisms have emerged as a potential avenue. With the advent of nanosystems and precision targeting, targeted therapy has now transcended the "comfort zone" erected by cancer cells within TME.
Conclusion: The ceaseless metamorphosis of TME fosters the intransigent resilience and proliferation of tumors. However, existing therapies have yet to surmount the formidable obstacles posed by TME. Therefore, scientists should investigate potential avenues for therapeutic intervention and design innovative pharmacological and clinical technologies.
Graphical Abstract
[http://dx.doi.org/10.1016/j.prp.2020.152915] [PMID: 32146002]
[http://dx.doi.org/10.1038/s41571-019-0293-2] [PMID: 31792354]
[http://dx.doi.org/10.1084/jem.188.12.2205] [PMID: 9858507]
[http://dx.doi.org/10.1038/s41577-019-0221-9] [PMID: 31570879]
[http://dx.doi.org/10.1038/ni.2035] [PMID: 21739672]
[http://dx.doi.org/10.1016/j.immuni.2016.07.021] [PMID: 27533016]
[http://dx.doi.org/10.1038/nature13954] [PMID: 25428505]
[http://dx.doi.org/10.3389/fimmu.2020.622509] [PMID: 33633741]
[http://dx.doi.org/10.1126/science.aaf2807] [PMID: 27789795]
[http://dx.doi.org/10.1038/s41590-019-0312-6] [PMID: 30778252]
[http://dx.doi.org/10.1136/jitc-2022-005020] [PMID: 36192086]
[http://dx.doi.org/10.3389/fimmu.2022.1046755] [PMID: 36569893]
[http://dx.doi.org/10.3389/fimmu.2022.935465] [PMID: 35844620]
[http://dx.doi.org/10.1016/j.cmet.2021.02.015] [PMID: 33691090]
[http://dx.doi.org/10.1136/jitc-2022-005126] [PMID: 36787938]
[http://dx.doi.org/10.1136/jitc-2021-002603] [PMID: 34083422]
[http://dx.doi.org/10.1080/2162402X.2022.2158610] [PMID: 36545256]
[http://dx.doi.org/10.1158/2326-6066.CIR-22-0439] [PMID: 36484740]
[http://dx.doi.org/10.1136/jitc-2022-005433]
[http://dx.doi.org/10.3389/fimmu.2022.1022638] [PMID: 36685566]
[http://dx.doi.org/10.1186/s13045-022-01322-3] [PMID: 35948909]
[http://dx.doi.org/10.1016/j.cellimm.2020.104160] [PMID: 32711171]
[http://dx.doi.org/10.3389/fimmu.2022.940052] [PMID: 36248808]
[http://dx.doi.org/10.3390/cancers13081850] [PMID: 33924428]
[http://dx.doi.org/10.3389/fimmu.2019.02839] [PMID: 31849995]
[http://dx.doi.org/10.1038/s41590-019-0589-5] [PMID: 32066953]
[http://dx.doi.org/10.1038/s41586-021-03235-6] [PMID: 33627871]
[http://dx.doi.org/10.1038/s41586-021-03326-4] [PMID: 33588426]
[http://dx.doi.org/10.1038/s41467-021-26091-4] [PMID: 34599187]
[http://dx.doi.org/10.3389/fcell.2022.911811] [PMID: 35927985]
[http://dx.doi.org/10.1038/s41590-021-00958-6] [PMID: 34168370]
[http://dx.doi.org/10.3389/fimmu.2022.859738] [PMID: 35514957]
[http://dx.doi.org/10.1155/2022/1345971] [PMID: 35935577]
[http://dx.doi.org/10.1136/jitc-2022-004605] [PMID: 35618289]
[http://dx.doi.org/10.1136/jitc-2022-005241] [PMID: 36319063]
[http://dx.doi.org/10.1002/ctm2.992] [PMID: 35969010]
[http://dx.doi.org/10.1136/jitc-2022-005151] [PMID: 36126994]
[http://dx.doi.org/10.1136/jitc-2022-005326] [PMID: 36316062]
[http://dx.doi.org/10.1186/s13045-022-01282-8] [PMID: 35585567]
[http://dx.doi.org/10.1080/2162402X.2022.2141007] [PMID: 36352891]
[http://dx.doi.org/10.3389/fimmu.2022.835690] [PMID: 35251028]
[http://dx.doi.org/10.1136/jitc-2021-004235] [PMID: 36316061]
[http://dx.doi.org/10.2147/IJN.S346341] [PMID: 36172007]
[http://dx.doi.org/10.1038/s41416-022-01917-0] [PMID: 35986086]
[http://dx.doi.org/10.1136/jitc-2022-004806] [PMID: 36427906]
[http://dx.doi.org/10.1038/ni.3790] [PMID: 28722720]
[http://dx.doi.org/10.1073/pnas.1113744109] [PMID: 22308361]
[http://dx.doi.org/10.1038/nrclinonc.2016.217] [PMID: 28117416]
[http://dx.doi.org/10.1146/annurev-pathmechdis-012418-012718] [PMID: 31530089]
[http://dx.doi.org/10.1101/gad.1383206] [PMID: 16452502]
[http://dx.doi.org/10.1042/BSR20160105] [PMID: 27354564]
[http://dx.doi.org/10.1371/journal.pone.0159724] [PMID: 27447824]
[http://dx.doi.org/10.1172/JCI81656] [PMID: 26436647]
[http://dx.doi.org/10.1016/j.it.2013.02.003] [PMID: 23498847]
[http://dx.doi.org/10.1016/j.cmet.2019.06.001] [PMID: 31269428]
[http://dx.doi.org/10.3389/fimmu.2022.874589] [PMID: 35592338]
[http://dx.doi.org/10.1016/j.ccell.2021.04.016] [PMID: 34019807]
[http://dx.doi.org/10.3389/fimmu.2021.741305] [PMID: 34603327]
[http://dx.doi.org/10.1158/1078-0432.CCR-18-1390] [PMID: 30206165]
[http://dx.doi.org/10.1126/scitranslmed.aal3604] [PMID: 28490665]
[http://dx.doi.org/10.1186/s12885-022-09713-y] [PMID: 35658848]
[http://dx.doi.org/10.1002/JLB.MR0218-056RR] [PMID: 30720887]
[http://dx.doi.org/10.1016/j.ccell.2014.09.006] [PMID: 25446896]
[http://dx.doi.org/10.1002/cjp2.267] [PMID: 35318822]
[http://dx.doi.org/10.1158/0008-5472.CAN-14-3587] [PMID: 26269531]
[http://dx.doi.org/10.1007/s10585-017-9870-x] [PMID: 29307118]
[http://dx.doi.org/10.3389/fonc.2022.1020606] [PMID: 36249052]
[http://dx.doi.org/10.15252/emmm.201809342] [PMID: 30442705]
[http://dx.doi.org/10.1158/0008-5472.CAN-17-3623] [PMID: 29880480]
[http://dx.doi.org/10.3389/fphar.2020.574667] [PMID: 33363463]
[http://dx.doi.org/10.1101/gad.294348.116] [PMID: 28223311]
[http://dx.doi.org/10.1016/j.omto.2022.02.019] [PMID: 35317518]
[http://dx.doi.org/10.1200/JCO.18.02018] [PMID: 30811285]
[http://dx.doi.org/10.1038/s41467-022-32091-9] [PMID: 35927238]
[http://dx.doi.org/10.1038/s41467-020-20723-x] [PMID: 33469052]
[http://dx.doi.org/10.3390/cells11203183] [PMID: 36291050]
[http://dx.doi.org/10.3390/cancers14051179] [PMID: 35267487]
[http://dx.doi.org/10.1084/jem.20190673] [PMID: 32453421]
[http://dx.doi.org/10.1186/s12943-022-01515-x] [PMID: 35148751]
[http://dx.doi.org/10.1136/jitc-2019-000474] [PMID: 32273347]
[http://dx.doi.org/10.37349/etat.2022.00115] [PMID: 36654820]
[http://dx.doi.org/10.3389/fimmu.2022.1074644] [PMID: 36741387]
[http://dx.doi.org/10.3389/fimmu.2022.950079] [PMID: 36703982]
[http://dx.doi.org/10.1186/s13045-022-01335-y] [PMID: 36031601]
[http://dx.doi.org/10.1136/jitc-2021-003571] [PMID: 34987021]
[http://dx.doi.org/10.1186/s13046-022-02289-2] [PMID: 35459193]
[http://dx.doi.org/10.1186/s12885-022-10356-2] [PMID: 36451110]
[http://dx.doi.org/10.1136/jitc-2021-004049] [PMID: 35101946]
[http://dx.doi.org/10.1136/jitc-2021-003663] [PMID: 35193930]
[http://dx.doi.org/10.1186/s12885-022-10435-4] [PMID: 36527024]
[http://dx.doi.org/10.1186/s12943-023-01737-7] [PMID: 36797782]
[http://dx.doi.org/10.1182/blood-2008-02-135871] [PMID: 18579793]
[http://dx.doi.org/10.4161/21624011.2014.952197] [PMID: 25610741]
[http://dx.doi.org/10.3390/cancers13092184] [PMID: 34062821]
[http://dx.doi.org/10.4049/jimmunol.181.6.3784] [PMID: 18768831]
[http://dx.doi.org/10.3389/fimmu.2021.643310] [PMID: 33995362]
[http://dx.doi.org/10.1186/s12977-015-0191-3] [PMID: 26220086]
[http://dx.doi.org/10.1073/pnas.2101169118] [PMID: 34244432]
[http://dx.doi.org/10.1093/jnci/dju200] [PMID: 25178695]
[http://dx.doi.org/10.1186/s12929-022-00866-3] [PMID: 36253762]
[http://dx.doi.org/10.3389/fimmu.2022.953849] [PMID: 35990652]
[http://dx.doi.org/10.1016/j.stem.2021.08.013] [PMID: 34525347]
[http://dx.doi.org/10.3389/fonc.2022.886440] [PMID: 35712510]
[http://dx.doi.org/10.3389/fimmu.2021.624324] [PMID: 33953707]
[http://dx.doi.org/10.1007/s00262-021-03126-9] [PMID: 34999917]
[http://dx.doi.org/10.3389/fimmu.2023.1152572] [PMID: 37090711]
[http://dx.doi.org/10.3390/cancers14215438] [PMID: 36358857]
[http://dx.doi.org/10.1038/s41416-022-02076-y] [PMID: 36463323]
[http://dx.doi.org/10.1007/s40259-022-00572-4] [PMID: 36525216]
[http://dx.doi.org/10.1186/s12935-023-02923-9] [PMID: 37158883]
[http://dx.doi.org/10.3390/cancers14112749] [PMID: 35681730]
[http://dx.doi.org/10.1158/0008-5472.CAN-21-4141] [PMID: 35749591]
[http://dx.doi.org/10.1038/s41388-022-02540-2] [PMID: 36418470]
[http://dx.doi.org/10.1158/1078-0432.CCR-21-3570] [PMID: 35262677]
[http://dx.doi.org/10.3390/cancers15020335] [PMID: 36672284]
[http://dx.doi.org/10.3390/biomedicines11010112] [PMID: 36672620]
[http://dx.doi.org/10.1515/hsz-2022-0253] [PMID: 36594183]
[http://dx.doi.org/10.1038/s43018-022-00411-z] [PMID: 35883004]
[http://dx.doi.org/10.1038/s41420-023-01306-3] [PMID: 36635302]
[http://dx.doi.org/10.3390/biology12010110] [PMID: 36671802]
[http://dx.doi.org/10.1002/advs.202101235] [PMID: 34791825]
[http://dx.doi.org/10.1038/s41467-022-34395-2] [PMID: 36333338]
[http://dx.doi.org/10.1016/j.ebiom.2017.02.019] [PMID: 28258923]
[http://dx.doi.org/10.1038/s41467-023-35793-w] [PMID: 36635273]
[http://dx.doi.org/10.1016/j.ymthe.2022.08.019] [PMID: 36045587]
[http://dx.doi.org/10.1111/cas.15601] [PMID: 36169301]
[http://dx.doi.org/10.3390/cancers14163906] [PMID: 36010899]
[http://dx.doi.org/10.1136/gutjnl-2020-322924] [PMID: 33692094]
[http://dx.doi.org/10.1016/j.celrep.2022.110792] [PMID: 35545049]
[http://dx.doi.org/10.3390/ijms24032555] [PMID: 36768876]
[http://dx.doi.org/10.1016/j.stem.2018.12.009] [PMID: 30609398]
[http://dx.doi.org/10.3390/ijms24021012] [PMID: 36674525]
[http://dx.doi.org/10.3390/ijms24032122] [PMID: 36768445]
[http://dx.doi.org/10.1016/j.redox.2023.102632] [PMID: 36791645]
[http://dx.doi.org/10.1038/s41418-022-00963-8] [PMID: 35301432]
[http://dx.doi.org/10.1038/s41586-022-05475-6] [PMID: 36450983]
[http://dx.doi.org/10.3390/cells11233790] [PMID: 36497050]
[http://dx.doi.org/10.1042/EBC20220016] [PMID: 35837811]
[http://dx.doi.org/10.1007/s12015-022-10426-9] [PMID: 35876959]
[http://dx.doi.org/10.1038/s41388-022-02391-x] [PMID: 35804016]
[http://dx.doi.org/10.3390/cells11050771] [PMID: 35269393]
[http://dx.doi.org/10.1186/s12943-015-0321-5] [PMID: 25743109]
[http://dx.doi.org/10.1111/febs.13603] [PMID: 26607558]
[http://dx.doi.org/10.1038/nrc2981] [PMID: 21258394]
[http://dx.doi.org/10.1038/nrd4002] [PMID: 24287781]
[http://dx.doi.org/10.1038/sigtrans.2017.36] [PMID: 29263924]
[http://dx.doi.org/10.1016/j.ccr.2008.11.003] [PMID: 19061837]
[http://dx.doi.org/10.1016/j.cub.2014.03.034] [PMID: 24845678]
[http://dx.doi.org/10.1038/ncomms7907] [PMID: 25892552]
[http://dx.doi.org/10.15252/embr.201949799] [PMID: 32202065]
[http://dx.doi.org/10.1186/s40170-015-0130-8] [PMID: 25810907]
[http://dx.doi.org/10.1016/j.cell.2011.02.013] [PMID: 21376230]
[http://dx.doi.org/10.1074/jbc.M111.280156] [PMID: 22157017]
[http://dx.doi.org/10.1242/jcs.072165] [PMID: 21940791]
[http://dx.doi.org/10.15252/embj.201695916] [PMID: 28465321]
[http://dx.doi.org/10.1038/nm.3394] [PMID: 24202395]
[http://dx.doi.org/10.3390/genes13101728] [PMID: 36292613]
[http://dx.doi.org/10.3389/fcell.2022.937753] [PMID: 35959487]
[http://dx.doi.org/10.3389/fphar.2022.1019312] [PMID: 36313354]
[http://dx.doi.org/10.7150/jca.62278] [PMID: 34976191]
[http://dx.doi.org/10.1038/s41422-022-00766-z] [PMID: 36627348]
[http://dx.doi.org/10.1111/cpr.13327] [PMID: 36200262]
[http://dx.doi.org/10.1016/j.cmet.2022.03.013] [PMID: 35452600]
[http://dx.doi.org/10.1080/15384047.2022.2029132] [PMID: 35129069]
[http://dx.doi.org/10.3390/nano12050743] [PMID: 35269231]
[http://dx.doi.org/10.1186/s12951-022-01453-2] [PMID: 35568916]
[http://dx.doi.org/10.1042/BSR20130066] [PMID: 24079832]
[http://dx.doi.org/10.1016/bs.acr.2019.03.004] [PMID: 31202359]
[http://dx.doi.org/10.1158/2326-6066.CIR-19-0115] [PMID: 31575551]
[http://dx.doi.org/10.1016/j.cell.2013.05.016] [PMID: 23746840]
[http://dx.doi.org/10.21037/atm-20-2037] [PMID: 32953830]
[http://dx.doi.org/10.1016/j.cell.2015.08.016] [PMID: 26321679]
[http://dx.doi.org/10.3389/fonc.2022.931104] [PMID: 35924168]
[http://dx.doi.org/10.3389/fonc.2022.1060495] [PMID: 36776368]
[http://dx.doi.org/10.1186/s12951-022-01762-6] [PMID: 36597089]
[http://dx.doi.org/10.1038/s41467-022-32521-8] [PMID: 36068198]
[http://dx.doi.org/10.1158/0008-5472.CAN-21-4052] [PMID: 35648389]
[http://dx.doi.org/10.1016/j.jcmgh.2022.07.008] [PMID: 35863742]
[http://dx.doi.org/10.3389/fgene.2022.849040] [PMID: 35432450]
[http://dx.doi.org/10.1097/MOL.0000000000000443] [PMID: 28692598]
[http://dx.doi.org/10.1126/sciadv.1600200] [PMID: 27386546]
[http://dx.doi.org/10.1016/j.plipres.2020.101055] [PMID: 32791170]
[http://dx.doi.org/10.1016/j.it.2021.11.007] [PMID: 34942082]
[http://dx.doi.org/10.1038/s41467-021-24331-1] [PMID: 34210970]
[http://dx.doi.org/10.3390/microorganisms10102048] [PMID: 36296324]
[http://dx.doi.org/10.1084/jem.20191920] [PMID: 32491160]
[http://dx.doi.org/10.3389/fonc.2019.01201] [PMID: 31803610]
[http://dx.doi.org/10.1111/cpr.12772] [PMID: 32003505]
[http://dx.doi.org/10.1158/2326-6066.CIR-18-0095] [PMID: 30143538]
[http://dx.doi.org/10.1016/j.cmet.2019.04.002] [PMID: 31031094]
[http://dx.doi.org/10.1186/s13045-021-01200-4] [PMID: 34742349]
[http://dx.doi.org/10.1084/jem.20142237] [PMID: 26034050]
[http://dx.doi.org/10.3390/biom12040580] [PMID: 35454171]
[http://dx.doi.org/10.1038/nrc.2016.71] [PMID: 27492215]
[http://dx.doi.org/10.1038/s41586-021-03442-1] [PMID: 33828302]
[http://dx.doi.org/10.1126/science.aav2588] [PMID: 31699883]
[http://dx.doi.org/10.3389/fimmu.2022.960738] [PMID: 36032135]
[http://dx.doi.org/10.1186/s12951-022-01424-7] [PMID: 35524267]
[http://dx.doi.org/10.1016/j.cell.2018.10.001] [PMID: 30392958]
[http://dx.doi.org/10.1002/advs.202105885] [PMID: 35861366]
[http://dx.doi.org/10.3389/fimmu.2022.807271] [PMID: 35173722]
[http://dx.doi.org/10.3390/cells11010140] [PMID: 35011702]
[http://dx.doi.org/10.1002/advs.202103887] [PMID: 35187863]