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. Author manuscript; available in PMC: 2013 Nov 21.
Published in final edited form as: Nat Rev Cancer. 2012 Jul 19;12(8):10.1038/nrc3278. doi: 10.1038/nrc3278

Figure 2. A model for the importance of the context of tumour stage for the biological consequences of NRF2 activation.

Figure 2

Enhancing NFE2-related factor 2 (NRF2) activity is important for the prevention of cancer, especially if low doses of drugs are used during the earliest stages of carcinogenesis. However, in fully malignant cells, enhancement of NRF2 activity (caused by mutations) can protect tumours from the cytotoxic effects of reactive oxygen species (ROS) that are induced by chemotherapy or that may be produced endogenously by oncogenic signalling in advanced tumours. The effects of NRF2 inducers on cells at intermediate stages of tumorigenesis are still largely unknown and need further investigation. Carcinogenesis is a continuum, and there may be many different premalignant genotypes and phenotypes within a given susceptible organ in vivo.