Obesity and cancer mechanisms: Tumor microenvironment and inflammation Journal Article


Authors: Iyengar, N. M.; Gucalp, A.; Dannenberg, A. J.; Hudis, C. A.
Article Title: Obesity and cancer mechanisms: Tumor microenvironment and inflammation
Abstract: Purpose: There is growing evidence that inflammation is a central and reversible mechanism through which obesity promotes cancer risk and progression. Methods: We review recent findings regarding obesity-associated alterations in the microenvironment and the local and systemic mechanisms through which these changes support tumor growth. Results: Locally, hyperadiposity is associated with altered adipose tissue function, adipocyte death, and chronic low-grade inflammation. Most individuals who are obese harbor inflamed adipose tissue, which resembles chronically injured tissue, with immune cell infiltration and remodeling. Within this distinctly altered local environment, several pathophysiologic changes are found that may promote breast and other cancers. Consistently, adipose tissue inflammation is associated with a worse prognosis in patients with breast and tongue cancers. Systemically, the metabolic syndrome, including dyslipidemia and insulin resistance, occurs in the setting of adipose inflammation and operates in concert with local mechanisms to sustain the inflamed microenvironment and promote tumor growth. Importantly, adipose inflammation and its protumor consequences can be found in some individuals who are not considered to be obese or overweight by body mass index. Conclusion: The tumor-promoting effects of obesity occur at the local level via adipose inflammation and associated alterations in the microenvironment, as well as systemically via circulating metabolic and inflammatory mediators associated with adipose inflammation. Accurately characterizing the obese state and identifying patients at increased risk for cancer development and progression will likely require more precise assessments than body mass index alone. Biomarkers of adipose tissue inflammation would help to identify high-risk populations. Moreover, adipose inflammation is a reversible process and represents a novel therapeutic target that warrants further study to break the obesity-cancer link. © 2016 by American Society of Clinical Oncology.
Journal Title: Journal of Clinical Oncology
Volume: 34
Issue: 35
ISSN: 0732-183X
Publisher: American Society of Clinical Oncology  
Date Published: 2016-12-10
Start Page: 4270
End Page: 4276
Language: English
DOI: 10.1200/jco.2016.67.4283
PROVIDER: scopus
PUBMED: 27903155
PMCID: PMC5562428
DOI/URL:
Notes: Article -- Export Date: 3 January 2017 -- Source: Scopus
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  1. Clifford Hudis
    905 Hudis
  2. Ayca Gucalp
    113 Gucalp
  3. Neil Mukund Iyengar
    150 Iyengar