# Quail and Joyce 2013: microenvironmental regulation of tumour progression and metastasis

Source: https://onco.cc/key-papers/paper-quail-joyce-microenvironment-metastasis-natmed-2013/  
OnCo record `paper-quail-joyce-microenvironment-metastasis-natmed-2013` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

A review of how the normal cells around a tumour, including fibroblasts, immune cells and blood vessels, are recruited to help it grow and spread, and how distant organs are prepared to receive metastases before the cancer cells arrive.

## Summary

Quail and Joyce surveyed the tumour microenvironment at each step of progression and metastasis: how cancer-associated fibroblasts, tumour-associated macrophages, other myeloid and lymphoid cells and the vasculature support primary tumour growth, invasion and intravasation; how bone marrow-derived cells and tumour-secreted factors establish a pre-metastatic niche in distant organs; and how the microenvironment at secondary sites governs dormancy and outgrowth. They discussed therapies aimed at these host cells, including macrophage-targeting and anti-angiogenic drugs, as complements to treatments aimed at the cancer cell.

## Fields

- Kind: Key paper
- Last checked: 2026-09-08
- Journal: Nature Medicine
- Year: 2013
- DOI: 10.1038/nm.3394
- Authors: Quail DF, Joyce JA.
- Findings: Stromal, immune and vascular cells are co-opted at every stage from primary growth to metastatic colonisation.; Tumour-derived factors and bone marrow-derived cells prepare pre-metastatic niches in distant organs before cancer cells arrive.; The microenvironment at secondary sites controls whether disseminated cells stay dormant or grow out.
- What it means: This review is the standard map of the tumour microenvironment and the reason microenvironment-directed drugs, from anti-angiogenics to macrophage and fibroblast targeting agents, are developed alongside tumour-cell-directed ones.
- Caveats: A review; many mechanisms rest on mouse models.; Microenvironment-targeted therapies have had mixed clinical success so far.

## Sources

- Full text (DOI): https://doi.org/10.1038/nm.3394

## Connected records

- key papers: [Coussens and Werb 2002: inflammation and cancer](https://onco.cc/key-papers/paper-coussens-werb-inflammation-cancer-nature-2002/)
- technologies: [Anti-angiogenic therapy](https://onco.cc/technologies/antiangiogenic/)
- targets: [CSF1R](https://onco.cc/targets/csf1r/)
- institutions: [Memorial Sloan Kettering Cancer Center](https://onco.cc/institutions/mskcc/)
- pathways: [The metastatic cascade](https://onco.cc/pathways/metastatic-cascade/), [The pre-metastatic niche](https://onco.cc/pathways/pre-metastatic-niche/), [Tumour microenvironment (TME)](https://onco.cc/pathways/tumor-microenvironment/)
- terms: [Angiogenesis](https://onco.cc/terms/angiogenesis/), [Cancer-associated fibroblasts (CAFs)](https://onco.cc/terms/cancer-associated-fibroblasts/), [Metastasis](https://onco.cc/terms/metastasis/), [Microenvironment and inflammation: tumours as wounds that do not heal](https://onco.cc/terms/microenvironment-inflammation-theory/), [Tumour-associated macrophages (TAMs)](https://onco.cc/terms/tumor-associated-macrophages/)
- people: [Johanna Joyce](https://onco.cc/people/johanna-joyce/)

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