Book contents
- Frontmatter
- Contents
- Contributors
- Overview: Biology Is the Foundation of Therapy
- PART I BASIC RESEARCH
- PART II CLINICAL RESEARCH
- 23 Introduction to Clinical Research
- 24 Sarcoma
- 25 Neuroblastoma
- 26 Retinoblastoma
- 27 Primary Brain Tumors and Cerebral Metastases
- 28 Head and Neck Cancer Metastasis
- 29 Cutaneous Melanoma: Therapeutic Approaches for Metastatic Disease
- 30 Gastric Cancer Metastasis
- 31 Metastatic Pancreatic Cancer
- 32 Metastasis of Primary Liver Cancer
- 33 Advances in Management of Metastatic Colorectal Cancer
- 34 Lung Cancer Metastasis
- 35 Metastatic Thyroid Cancer: Evaluation and Treatment
- 36 Metastatic Renal Cell Carcinoma
- 37 Bladder Cancer
- 38 Bone Complications of Myeloma and Lymphoma
- 39 Breast Metastasis
- 40 Gynecologic Malignancies
- 41 Prostate Cancer Metastasis: Thoughts on Biology and Therapeutics
- 42 The Biology and Treatment of Metastatic Testicular Cancer
- 43 Applications of Proteomics to Metastasis Diagnosis and Individualized Therapy
- 44 Critical Issues of Research on Circulating and Disseminated Tumor Cells in Cancer Patients
- 45 Lymphatic Mapping and Sentinel Lymph Node Biopsy
- 46 Molecular Imaging and Metastasis
- 47 Preserving Bone Health in Malignancy and Complications of Bone Metastases
- 48 Role of Platelets and Thrombin in Metastasis
- THERAPIES
- 49 Cancer Nanotechnology Offers Great Promise for Cancer Research and Therapy
- 50 Metronomic Chemotherapy for Treatment of Metastatic Disease: From Preclinical Research to Clinical Trials
- 51 Immunotherapy
- 52 Discovery and Development of Drugs Targeting Tumor Invasion and Metastasis
- 53 The Role of Radiotherapy in the Treatment of Metastatic Disease
- 54 Prospects for Clinical Trials of Metastasis Inhibitors
- Index
- References
54 - Prospects for Clinical Trials of Metastasis Inhibitors
from THERAPIES
Published online by Cambridge University Press: 05 June 2012
- Frontmatter
- Contents
- Contributors
- Overview: Biology Is the Foundation of Therapy
- PART I BASIC RESEARCH
- PART II CLINICAL RESEARCH
- 23 Introduction to Clinical Research
- 24 Sarcoma
- 25 Neuroblastoma
- 26 Retinoblastoma
- 27 Primary Brain Tumors and Cerebral Metastases
- 28 Head and Neck Cancer Metastasis
- 29 Cutaneous Melanoma: Therapeutic Approaches for Metastatic Disease
- 30 Gastric Cancer Metastasis
- 31 Metastatic Pancreatic Cancer
- 32 Metastasis of Primary Liver Cancer
- 33 Advances in Management of Metastatic Colorectal Cancer
- 34 Lung Cancer Metastasis
- 35 Metastatic Thyroid Cancer: Evaluation and Treatment
- 36 Metastatic Renal Cell Carcinoma
- 37 Bladder Cancer
- 38 Bone Complications of Myeloma and Lymphoma
- 39 Breast Metastasis
- 40 Gynecologic Malignancies
- 41 Prostate Cancer Metastasis: Thoughts on Biology and Therapeutics
- 42 The Biology and Treatment of Metastatic Testicular Cancer
- 43 Applications of Proteomics to Metastasis Diagnosis and Individualized Therapy
- 44 Critical Issues of Research on Circulating and Disseminated Tumor Cells in Cancer Patients
- 45 Lymphatic Mapping and Sentinel Lymph Node Biopsy
- 46 Molecular Imaging and Metastasis
- 47 Preserving Bone Health in Malignancy and Complications of Bone Metastases
- 48 Role of Platelets and Thrombin in Metastasis
- THERAPIES
- 49 Cancer Nanotechnology Offers Great Promise for Cancer Research and Therapy
- 50 Metronomic Chemotherapy for Treatment of Metastatic Disease: From Preclinical Research to Clinical Trials
- 51 Immunotherapy
- 52 Discovery and Development of Drugs Targeting Tumor Invasion and Metastasis
- 53 The Role of Radiotherapy in the Treatment of Metastatic Disease
- 54 Prospects for Clinical Trials of Metastasis Inhibitors
- Index
- References
Summary
TARGETS FOR METASTASIS SUPPRESSION
The process of metastasis has been carefully delineated in recent decades and includes intravasation, survival in the circulation, and arrest in a distant organ; extravasation, survival, and growth after extravasation; and persistence of growth. Although an enormous amount of research has examined the early steps of the metastatic process, it seems unlikely that the earliest steps are amenable to therapeutic intervention. In general, distant metastasis has occurred in the majority of human cancers prior to detection of the primary tumor. In some tumors (e.g., pancreatic cancer) overt metastatic disease is common at diagnosis, whereas in other cancers (e.g., breast and colorectal cancers) micrometastatic disease is present at the time of diagnosis. In either situation, circulating tumor cells have lodged in a distant site long before a patient meets a physician.
Where in the metastatic process will the therapeutic line be drawn? Certainly this will occur somewhere following intravasation and spread through the circulation, and quite possibly following organ arrest (depending on whether tumor dormancy occurs at this point or at a subsequent point, as discussed later). Regardless, metastasis suppression strategies posited solely on interruption of the earliest steps of the metastatic process are unlikely to prove successful in most cases.
There are possible exceptions to the above rule that might render treatment of the early portions of the metastatic process valuable.
- Type
- Chapter
- Information
- Cancer MetastasisBiologic Basis and Therapeutics, pp. 622 - 626Publisher: Cambridge University PressPrint publication year: 2011