Inflammation as target in cancer therapy

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HIGHLIGHTSChronic inflammation increases the risk of carcinogenesis and tumour progression.Macrophages in tumours are the major source of inflammatory mediators.Cancer-promoting inflammation is a promising target of therapy in oncology.Inhibitors of inflammatory pathways proved to be successful in pre-clinical settings.Some anti-inflammatory agents alone, or in combination, are used in oncology.Cells of the innate immunity infiltrating tumour tissues promote, rather than halt, cancer cell proliferation and distant spreading. Tumour-Associated Macrophages (TAMs) are abundantly present in the tumour milieu and here trigger and perpetrate a state of chronic inflammation which ultimately supports disease development and contributes to an immune-suppressive environment. Therapeutic strategies to limit inflammatory cells and their products have been successful in pre-clinical tumour models. Early clinical trials with specific cytokine and chemokine inhibitors, or with strategies designed to target TAMs, are on their way in different solid malignancies. Partial clinical responses and stabilization of diseases were observed in some patients, in the absence of significant toxicity. These encouraging results open new perspectives of combination treatments aimed at reducing cancer-promoting inflammation to maximize the anti-tumour efficacy.

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