Tumors often start out as a benign growth, but gradually progress
toward the malignant stage over a relatively long period of time.
Tumor progression results from accumulated genetic mutations and
inheritable epigenetic modifications that enable clonal evolution
and selection of new clonal populations of tumor cells with
aggressive characteristics including metastasis and therapy
resistance. Increasing amounts of experimental evidence suggests
that tumor microenvironment play a significant role in directing
clonal evolution and determining clonal cell fate, which eventually
leads to emergence of malignant tumor cell clones. Hypoxia is the
most commonly observed feature of tumor microenvironment. Tumor
hypoxia is significantly associated with malignant progression and
predicts poor patient outcomes. This book provides detailed and
up-to-date treaties on the role of hypoxia as a major driving force
in tumor microenvironment to elicit cellular adaptation and clonal
selection via genetic mutations and epigenetic modifications, to
facilitate cancer stem cell maintenance, to enhance metastasis, to
augment therapy resistance, and to evade immune surveillance.
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