New data indicate that primary dysfunction in the tumour microenvironment, in addition to epithelial dysfunction, can be crucial for carcinogenesis. These recent findings make a compelling case for targeting the microenvironment for cancer chemoprevention. We review new insights into the pathophysiology of the microenvironment and new approaches to control it with chemopreventive agents. The microenvironment of a cancer is an integral part of its anatomy and physiology, and functionally, one cannot totally dissociate this microenvironment from what have traditionally been called 'cancer cells'. Finally, we make suggestions for more effective clinical implementation of this knowledge in preventive strategies.
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We thank M. Padgett for expert editorial and stylistic assistance in the preparation of this manuscript. K. Liby, F. Tosetti, R. Benelli and D. Noonan have given valuable suggestions and comments. We are especially indebted to C. Leaf for comments about 'risk versus risk'. A.A. is supported by grants from the Associazione Italiana per la Ricerca sul Cancro (AIRC) and Ministero della Salute. M.B.S. is supported by grants from the US National Cancer Institute and the National Foundation for Cancer Research.
The authors declare no competing financial interests.
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Albini, A., Sporn, M. The tumour microenvironment as a target for chemoprevention. Nat Rev Cancer 7, 139–147 (2007). https://doi.org/10.1038/nrc2067
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