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Targeting a Hallmark of Cancer: Simultaneous Inflammation and Tumor Control for Palliative Care in Metastatic Cancer

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Abstract

Clinical attenuation of the inflammation-related symptom complex, comprising cachexia, anorexia, fatigue, depression, neuropathic pain, anxiety, cognitive impairment, sleep disorder and delirium, is of extreme importance to improve palliative care in metastatic cancer. Laboratory data provide strong evidence that pro-inflammatory processes are related to multifold clinical disease traits of metastatic cancer and that pro-inflammatory processes are even drivers of tumor progression; however, approaches for attenuating pro-inflammatory processes with single-track or combined single-track therapies repetitively show—as reviewed here—controversial data about the benefit of anti-inflammatory therapies. What are the reasons for the conflicting data? Recently published clinical data indicate that inflammation control in different metastatic tumor types requires differential therapeutic access, because pro-inflammatory processes are multifacetedly rationalized. Beyond the control of inflammation-related clinical symptoms (improved ECOG status) inflammation control is associated with attenuation of tumor growth. Tumor-specific rationalizations provide highly specific targets: Inflammation—as a ubiquitous tumor-associated normative notion—may be constituted in multiple ways, supported by quite different cell types of the tumor compartment. Dependent on the physical constitution of tumor-associated rationalization processes the interfaces to other rationalization processes, e.g., immune response or angiogenesis become displaced and form an obstacle for single-track approaches. Combined modularized, primarily multi-track therapies account for such displacements.

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  1. Department of Hematology and Oncology, University Hospital Regensburg, 93042, Regensburg, Germany

    J. Pfirstinger, A. Reichle & J. Grassinger

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    Albrecht Reichle

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Pfirstinger, J., Reichle, A., Grassinger, J. (2013). Targeting a Hallmark of Cancer: Simultaneous Inflammation and Tumor Control for Palliative Care in Metastatic Cancer. In: Reichle, A. (eds) Evolution-adjusted Tumor Pathophysiology:. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-6866-6_21

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