TNF and neoplasm: In high concentrations, TNF-α provides an anti-tumor action by mediating cellular apoptosis, directing tumor-associated macrophages to anti-tumoral phenotypes, guiding neutrophils and monocytes to tumor sites, activating macrophages and inhibiting monocyte differentiation to immunosuppressive phenotypes, and inducing the disruption of tumor vasculature; in contrast, TNF-α expression at low levels can be pro-tumorigenic [14].