Cancer associated fibroblasts (CAFs) and the derived stromal components constitute specific pathological stroma in desmoplastic tumors, which not only hinder the distribution of drugs/nano-agents in tumors but also reduce the sensibility of tumor cells to standard therapeutics. Consequently, pathological stroma has gradually been termed potential target for antitumor therapy. However, opposite outcomes have been observed to occur with the same strategy in different tumor models and no general principles have been adopted due to the heterogeneity and adaptivity of dynamic stroma, in which case diversified strategies for antitumor therapies are urgent. In this review, we summarize the origins and characterizations of pathological stroma and describe their critical influence on tumor's responsiveness to oncotherapy. The design of combinational antitumor strategies and stroma targeting drug delivery systems (DDSs) are also discussed in detail. Collectively, the main purpose of this review is to improve our understanding of the roles of stroma in tumor progression and provide new insights for targeting pathological stroma.
Keywords: CAFs; Combinational therapies; Drug delivery system; Stroma; Tumor microenvironment.
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