The Complexities of Metastasis

Cancers (Basel). 2019 Oct 16;11(10):1575. doi: 10.3390/cancers11101575.


Therapies that prevent metastatic dissemination and tumor growth in secondary organs are severely lacking. A better understanding of the mechanisms that drive metastasis will lead to improved therapies that increase patient survival. Within a tumor, cancer cells are equipped with different phenotypic and functional capacities that can impact their ability to complete the metastatic cascade. That phenotypic heterogeneity can be derived from a combination of factors, in which the genetic make-up, interaction with the environment, and ability of cells to adapt to evolving microenvironments and mechanical forces play a major role. In this review, we discuss the specific properties of those cancer cell subgroups and the mechanisms that confer or restrict their capacity to metastasize.

Keywords: CTC-clusters; biomechanics; circulating tumor cells (CTCs), extracellular vesicles; epigenetics; epithelial-to-mesenchymal transition; heterogeneity; metastasis; metastatic niche; plasticity.

Publication types

  • Review