In addition to the changes within the tumor cell, secreted soluble factors originating from macrophages in the tumor microenvironment contribute to resistance, including tumor necrosis factor-α (TNF-α) and vascular endothelial growth factor (VEGF), which contribute to tumor cell growth and invasion, and further infiltration of macrophages and T-lymphocytes into the tumor microenvironment [175,176]. This evidence concerns the gene VEGFA and neoplasm.