Corrupt policemen: inflammatory cells promote tumor angiogenesis

Purpose of review The last decade has seen a paradigm change in that tumor stroma contributes to malignant tumor progression in a manner comparable to genetic and epigenetic changes within cancer cells. This review summarizes recent novel insights into how inflammatory conditions stimulate the formation and expansion of blood and lymphatic vessels within tumors and, thus, allow tumors to grow, to gain invasive capabilities, and to finally seed metastasis in distant organs. Recent findings Different cancer types have a highly defined microenvironment, which is composed of cancer-associated fibroblasts, blood vessel and lymphatic endothelial cells, pericytes, and a heterogeneous infiltrate of cells of the immune system. In addition to the local stimulation of tumor angiogenesis and tumor lymphangiogenesis, cytokines released by the primary tumor and by the immune cell infiltrate also instruct bone marrow-derived cells to colonize distant organs and to prepare these sites for future metastasis. Summary Inflammatory reactions coinciding with carcinogenesis can be visualized by the presence of specific bone marrow-derived, inflammatory cells in patients' peripheral blood. Recent findings suggest that such inflammatory fingerprints may better define the inflammatory nature of the primary malignancy and, thus, allow the design of therapeutic strategies targeting the protumorigenic immune cell stroma compartment.