Obesity is a rising epidemic, the influence of which on cancer development, progression as well as its impact on current standard of care cancer treatments is profound with many facets. Obesity is emerging as a modulating factor in many cancer therapies, such as chemotherapy, radiotherapy, immunotherapy and combination therapies. It has reported to diminish the efficacy of some treatments but had also been alluded to being protective in terms of reduced treatment toxicities, thus the evolution of the obesity paradox. The obese tumour microenvironment influences treatment response through modulation of a series of aspects, including altered adipocyte secretome, angiogenesis, hypoxia, fibrosis, free fatty acid uptake as well as a modulated immune landscape. However, the influence of these underlying mechanisms on cancer treatment response and the biological action of adipose tissue is still largely unknown. Elucidation of these facets may lead to the enhanced efficacy of current treatment options or the identification of novel methods to combat cancer in the obese tumour microenvironment.

肥胖症是一种日益严重的流行病，其对癌症发展、进展以及对当前癌症治疗标准的影响是深远的，具有多方面的意义。肥胖正在成为许多癌症疗法的调节因素，例如化学疗法、放射疗法、免疫疗法和联合疗法。据报道，它会降低某些治疗的功效，但也被暗示在降低治疗毒性方面具有保护作用，从而导致肥胖悖论的演变。肥胖的肿瘤微环境通过调节一系列方面影响治疗反应，包括改变的脂肪细胞分泌组、血管生成、缺氧、纤维化、游离脂肪酸摄取以及调节的免疫景观。然而，这些潜在机制对癌症治疗反应和脂肪组织的生物学作用的影响在很大程度上仍是未知的。阐明这些方面可能会提高当前治疗方案的疗效或确定在肥胖肿瘤微环境中对抗癌症的新方法。