Despite progress in the adjuvant systemic therapy for breast cancer over the past 30 years, 20-30% of women still have distant recurrence, and current regimens of cytotoxic and antihormonal therapies are likely to reach aplateau of efficacy. Novel strategies and approaches will be needed to push 5-10-year disease-free survival above 80-90%. Targeting of the cancer microenvironment is one such potential approach. This concept is not new: as early as 1889, Sir Stephen Paget suggested that disruption of the "soil" in which cancer cells reside could be useful therapeutically.
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