Abstract
Chemotherapy is a well-known and effective treatment for different cancers; unfortunately, it has not been as efficient in the eradication of all cancer cells as been expected. The mechanism of this failure was not fully clarified, yet. Meanwhile, alterations in the physiologic conditions of the tumor microenvironment (TME) were suggested as one of the underlying possibilities. Chemotherapy drugs can activate multiple signaling pathways and augment the secretion of inflammatory mediators. Inflammation may show two opposite roles in the TME. On the one hand, inflammation, as an innate immune response, tries to suppress tumor growth but on the other hand, it might be not powerful enough to eradicate the cancer cells and even it can provide appropriate conditions for cancer promotion and relapse as well. Therefore, the administration of mild anti-inflammatory drugs during chemotherapy might result in more successful clinical results. Here, we will review and discuss this hypothesis.
Graphic abstract
Most chemotherapy agents are triggers of inflammation in the tumor microenvironment through inducing the production of senescence-associated secretory phenotype (SASP) molecules. Some chemotherapy agents can induce systematic inflammation by provoking TLR4 signaling or triggering IL-1B secretion through the inflammasome pathway. NF-kB and MAPK are key signaling pathways of inflammation and could be activated by several chemotherapy drugs. Furthermore, inflammation can play a key role in cancer development, metastasis and exacerbation.
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Change history
28 August 2021
A Correction to this paper has been published: https://doi.org/10.1007/s00262-021-03034-y
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This study was partly supported by grant number 16572 from Iran University of Medical Sciences, Tehran, Iran.
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Supplementary Figure: Some chemotherapy drugs can increase inflammation in the TME. Most of the chemotherapy drugs cause tumor cells to become senescent, which can increase inflammation by producing senescence-associated secretory phenotype (SASP) including inflammatory cytokines, inflammatory chemokines, adhesion molecules, growth factors, and MMPs, e.g., IL-1, IL-6, IL-8, GM-CSF, and MCP-2. Doxorubicin and paclitaxel induce systematic inflammation by provoking TLR4 signaling. Doxorubicin, paclitaxel, and daunorubicin trigger IL-1B secretion through the inflammasome pathway. NF-kB and MAPK as crucial signaling pathways of inflammation are induced by most of the chemotherapy drugs and enhance generation of inflammatory elements. Supplementary file1 (PDF 368 kb)
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Behranvand, N., Nasri, F., Zolfaghari Emameh, R. et al. Chemotherapy: a double-edged sword in cancer treatment. Cancer Immunol Immunother 71, 507–526 (2022). https://doi.org/10.1007/s00262-021-03013-3
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DOI: https://doi.org/10.1007/s00262-021-03013-3