Review
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Jul 24, 2023; 14(7): 230-246
Published online Jul 24, 2023. doi: 10.5306/wjco.v14.i7.230
Stromal inflammation, fibrosis and cancer: An old intuition with promising potential
Oliver Oey, Angela Felicia Sunjaya, Yasir Khan, Andrew Redfern
Oliver Oey, Faculty of Medicine, University of Western Australia, Perth 6009, Crawley NA, Australia
Oliver Oey, Department of Medical Oncology, Sir Charles Gardner Hospital, Nedlands 6009, Australia
Angela Felicia Sunjaya, Institute of Cardiovascular Science, University College London, London WC1E 6DD, United Kingdom
Yasir Khan, Department of Medical Oncology, St John of God Midland Public and Private Hospital, Midland 6056, WA, Australia
Andrew Redfern, Department of Medical Oncology, Fiona Stanley Hospital, Murdoch 6150, WA, Australia
Author contributions: Oey O and Redfern A conceptualized the research idea; Oey O, Sunjaya AF, Khan Y, Redfern A all contributed towards study methodology, analysis, writing and editing of the manuscript; Redfern A and Yasir K supervised the manuscript preparation; All authors have read and agreed to the published version of the manuscript.
Conflict-of-interest statement: No conflicts of interest to be reported.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Angela Felicia Sunjaya, BMed, MD, Master's Student, Researcher, Institute of Cardiovascular Science, University College London, 62 Huntley St, London WC1E 6DD, United Kingdom. angelafelicia.s@gmail.com
Received: May 16, 2023
Peer-review started: May 16, 2023
First decision: May 25, 2023
Revised: June 7, 2023
Accepted: June 21, 2023
Article in press: June 21, 2023
Published online: July 24, 2023
Abstract

It is now well established that the biology of cancer is influenced by not only malignant cells but also other components of the tumour microenvironment. Chronic inflammation and fibrosis have long been postulated to be involved in carcinogenesis. Chronic inflammation can promote tumorigenesis via growth factor/cytokine-mediated cellular proliferation, apoptotic resistance, immunosuppression; and free-radical-induced oxidative deoxyribonucleic acid damage. Fibrosis could cause a perturbation in the dynamics of the tumour microenvironment, potentially damaging the genome surveillance machinery of normal epithelial cells. In this review, we will provide an in-depth discussion of various diseases characterised by inflammation and fibrosis that have been associated with an increased risk of malignancy. In particular, we will present a comprehensive overview of the impact of alterations in stromal composition on tumorigenesis, induced as a consequence of inflammation and/or fibrosis. Strategies including the application of various therapeutic agents with stromal manipulation potential and targeted cancer screening for certain inflammatory diseases which can reduce the risk of cancer will also be discussed.

Keywords: Inflammation, Fibrosis, Tumour microenvironment, Stroma, Cancer

Core Tip: Chronic inflammation and fibrosis have long been postulated to be involved in carcinogenesis via numerous mechanisms including but not limited to growth factor/cytokine-mediated cellular proliferation, apoptotic resistance, immunosuppression; and free-radical-induced oxidative deoxyribonucleic acid damage. In this review, we discuss various inflammatory and/or fibrotic conditions that have been associated with increased cancer risk, with particular emphasis on their pathophysiology. We also review various therapeutic agents and specific cancer screening that could be applicable in reducing the incidence of cancers developing from the corresponding inflammatory and/or fibrotic conditions, thereby reducing morbidity and mortality.