Inflammation is assessed as a hallmark of cancer and it is now widely recognized that there exists a direct causal link between inflammation and tumors. Among the inflammatory mediators, prostaglandin E2 (PGE2), the major product of cyclooxygenases (COXs), plays a pivotal role in tumor progression. Numerous pieces of evidence suggest that drugs, such as aspirin and non-steroidal anti-inflammatory drugs (NSAIDs) that inhibit PGE2 production, may exert a protective effect against tumor initiation and may play a role during tumor progression. In fact, a number of studies suggest that PGE2 increases tumor growth and invasion, reduces apoptosis, increases metastasis and angiogenesis, and suppresses antitumor immunity. In this review, we describe the current knowledge on the pro-tumoral activity of PGE2 focusing on its role in cancer progression and in the regulation of the tumor microenvironment.

The involvement of inflammation in cancer progression has been the subject of research for many years. Inflammatory milieu and immune response are associated with cancer progression and recurrence. In different types of tumors, growth and metastatic phenotype characterized by the epithelial mesenchymal transition (EMT) process, stemness, and angiogenesis, are increasingly associated with intrinsic or extrinsic inflammation. Among the inflammatory mediators, prostaglandin E2 (PGE2) supports epithelial tumor aggressiveness by several mechanisms, including growth promotion, escape from apoptosis, transactivation of tyrosine kinase growth factor receptors, and induction of angiogenesis. Moreover, PGE2 is an important player in the tumor microenvironment, where it suppresses antitumor immunity and regulates tumor immune evasion, leading to increased tumoral progression. In this review, we describe the current knowledge on the pro-tumoral activity of PGE2 focusing on its role in cancer progression and in the regulation of the tumor microenvironment.