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 :
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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.
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Re-organized collagen in the tumoral stroma confers metastatic properties to tumor cells.
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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.
![](https://assets-global.website-files.com/65af8a9de747e77ca6a3354d/65d62506c1f57513fa01de7f_Depiction-of-the-tumor-structure-Low.jpg)
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.