Figure 1. Chemotherapy induces the catabolic tumour stroma phenotype.
ROS production and DNA damage induced by chemotherapy generate oxidative stress to stromal cells, which in turn brings about several changes in them such as differentiation into CAFs, activation of HIF1α, NFkB, TGFβ, STAT3 or JNK/AP1 signalling pathways, switch to aerobic glycolysis and loss of functional mitochondria, acquisition of an autophagic and senescent phenotype, and release of pro-inflammatory cytokines. Thus, these stromal fibroblasts acquire the catabolic tumour stroma phenotype.