Figures & data
Figure 1. Therapeutic options against dormant and recurrent tumors. After the first-line treatment of the primary disease, cancer cells generally enter an extended period of dormancy. The evolution to an aggressive recurrence involves extensive phenotypic changes which result, in part at least, from the pressure of an innate immune responses targeting a rapidly expanding mass of cells. Understanding these phenotypic progression allows for the rational design of efficient therapies (in red). Dormant malignancies could first be uncovered upon premature reactivation by vascular endothelial growth factor (VEGF), and subsequently retreated efficiently with the frontline treatment used against the primary tumor. Dormant disease could also be treated using immunotherapeutic strategies that target the innate immune system, such as type I interferon, but only before the acquisition of a phenotype that in not susceptible to innate immune effectors is complete. Alternatively, the initiation of recurrence could be detected by markers of an ongoing immune response, for instance the circulating levels of VEGF and interleukin-6 (IL-6), guiding clinicians toward to the use of alternative therapies that efficiently target tumors insensitive to innate immune effectors.
