The role of senescence in cancer development.

While research on cancer development is traditionally focusing mainly on the neoplastic cell per se, nowadays the role of tumor stroma in this process is indisputable. The stroma - mainly composed of extracellular matrix (ECM) - is a source of mediators and signals originating from heterotypic cell-cell and cell-matrix interactions that steer the progression of the disease in a context- and a cancer type-dependent manner. With advancing age the stroma exhibits alterations, important being the accumulation of senescent cells. Senescence is often triggered by exogenous stresses, including genotoxic anticancer treatment modalities (such as chemotherapy or radiotherapy) and is manifested as an inhibition of cell proliferation, ascribing to cellular senescence the role of a potent antitumor barrier. On the other hand, senescent cells, through their specific senescence-associated secretory phenotype (SASP) - comprising cytokines, growth factors, ECM components and ECM-degrading enzymes - can establish an immunosuppressive, inflammatory and catabolic microenvironment that may stimulate tumor growth and metastasis. Given that the persistent presence of senescent cells could prove detrimental for tissue homeostasis, inclusion of a senotherapeutic arm in novel anticancer approaches seems compulsory.

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