TGF-β and cancer

The relationships between transforming growth factor-β (TGF-β) and cancer are varied and complex. The paradigm that is emerging from the experimental evidence accumulated over the past decade or so is that TGF-β can play two different and opposite roles with respect to the process of malignant progression. During early stages of carcinogenesis, TGF-β acts predominantly as a potent tumor suppressor and may mediate the actions of chemopreventive agents such as retinoids and nonsteroidal anti-estrogens. However, at some point during the development and progression of malignant neoplasms, bioactive TGF-βs make their appearance in the tumor microenvironment and the tumor cells escape from TGF-β-dependent growth arrest. In many cases, this resistance to TGF-β is the consequence of loss or mutational inactivation of the genes that encode signaling intermediates. These include the types I and II TGF-β receptors, as well as receptor-associated and common-mediator Smads. The stage of tumor development or progression at which TGF-β-resistant clones come to dominate the tumor cell population in different types of neoplasm remains to be defined. The phenotypic switch from TGF-β-sensitivity to TGF-β-resistance that occurs during carcinogenesis has several important implications for cancer prevention and treatment.