Tumour microenvironment in pheochromocytoma and paraganglioma

Front Endocrinol (Lausanne). 2023 Mar 22:14:1137456. doi: 10.3389/fendo.2023.1137456. eCollection 2023.

Abstract

Pheochromocytomas and Paragangliomas (Pheo/PGL) are rare catecholamine-producing tumours derived from adrenal medulla or from the extra-adrenal paraganglia respectively. Around 10-15% of Pheo/PGL develop metastatic forms and have a poor prognosis with a 37% of mortality rate at 5 years. These tumours have a strong genetic determinism, and the presence of succinate dehydrogenase B (SDHB) mutations are highly associated with metastatic forms. To date, no effective treatment is present for metastatic forms. In addition to cancer cells, the tumour microenvironment (TME) is also composed of non-neoplastic cells and non-cellular components, which are essential for tumour initiation and progression in multiple cancers, including Pheo/PGL. This review, for the first time, provides an overview of the roles of TME cells such as cancer-associated fibroblasts (CAFs) and tumour-associated macrophages (TAMs) on Pheo/PGL growth and progression. Moreover, the functions of the non-cellular components of the TME, among which the most representatives are growth factors, extracellular vesicles and extracellular matrix (ECM) are explored. The importance of succinate as an oncometabolite is emerging and since Pheo/PGL SDH mutated accumulate high levels of succinate, the role of succinate and of its receptor (SUCNR1) in the modulation of the carcinogenesis process is also analysed. Further understanding of the mechanism behind the complicated effects of TME on Pheo/PGL growth and spread could suggest novel therapeutic targets for further clinical treatments.

Keywords: cancer associated fibroblasts; catecholamines; extracellular matrix; pheochromocytoma/paraganglioma; tumour microenvironment.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adrenal Gland Neoplasms* / genetics
  • Adrenal Gland Neoplasms* / pathology
  • Humans
  • Paraganglioma* / genetics
  • Paraganglioma* / pathology
  • Pheochromocytoma* / genetics
  • Pheochromocytoma* / pathology
  • Succinates
  • Tumor Microenvironment

Substances

  • Succinates

Grants and funding

This research was supported by Fondazione AIRC per la Ricerca sul Cancro (under IG 2020 - ID. 24820 project) to M.M. Martinelli S, Rapizzi E, Maggi M, Canu L, are members of the Florence Center of Excellence recognized by the European Network for the Study of Adrenal Tumours (ENS@T).