Cancer A Complex Phenotype

Despite the extraordinarily valuable advances in oncogenomics of the tumor cell, in the end, cancer remains a phenotype. Vasculature, neighboring support structures, and local and systemic communications cannot be eliminated from the biology of a tumor; neither can systemwide effects on a person's well-being be ignored when developing a therapy. Indeed, some consider the basis of malignancy to be mediated by signaling between tumor epithelium and basement membrane and stroma. Recalling the normalization of EC cells in the embryonic environment, they propose to design therapeutics to revert the tumor cell phenotype by correcting only a minimum of signaling defects—even when the cells have suffered multiple genetic and epigenetic lesions—offering the remission of acute promyelocytic leukemia (APL) by retinoic acid-based therapies as an example (4).

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