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Cocciolo A, Di Domenico F, Coccia R, Fiorini A, Cai J, Pierce WM, Mecocci P, Butterfield DA, Perluigi M

Mol Genet Genomic Med 2019;7:e901

Because metabolic and epigenetic programmes interact to dictate cancer-cell state, co-targeting both processes may enhance therapeutic efficacy and diminish recurrence risk.174 Modulating the tumour micro-environment (TME): Dormancy is maintained by TME factors including hypoxia, cytokine milieu and extracellular-matrix stiffness, which also foster immune evasion and drug resistance.175 Strategies that re-engineer the TMEe.g., adjusting pH, oxygenation or extracellular-matrix compositionto improve drug penetration, invigorate antitumour immunity and curtail dormant-cell survival are therefore under active investigation.176 Conclusions Cancer recurrence remains a major clinical challenge, largely driven by two interrelated phenomena: cellular dormancy and cellular plasticity