Nature Reviews Clinical Oncology features a Focus on metastasis in the June and July 2011 issues. This focus features discussions of the recent breakthroughs in knowledge of the mechanisms and treatment of metastasis by key opinion leaders in the field. Topics include tumor self-seeding, metastasis-suppressor genes, bone metastasis, brain metastasis and oligometastases. The web page for this focus issue also includes links to related articles from across Nature Publishing Group to provide more background information on this topic.
EDITORIAL
New paradigms to explain metastasis
Lisa Hutchinson & Rebecca Kirk
doi:10.1038/nrclinonc.2011.68
Nature Reviews Clinical Oncology 8, 313 (2011)
REVIEWS
Rethinking the metastatic cascade as a therapeutic target
Lida A. Mina & George W. Sledge Jr
doi:10.1038/nrclinonc.2011.59
Nature Reviews Clinical Oncology 8, 325-332 (2011)
The treatment of microscopic metastatic disease is based on the assumption that micrometastases and overt metastases will respond to the same interventions; however, clinical observations illustrate this assumption is incorrect. The authors discuss our existing understanding of the metastatic cascade, emerging therapeutic targets involved in the metastatic process, and how novel anti-metastatic therapies might be developed for clinical use.
Metastasis-suppressor genes in clinical practice: lost in translation?
Alexander N. Shoushtari, Russell Z. Szmulewitz & Carrie W. Rinker-Schaeffer
doi:10.1038/nrclinonc.2011.65
Nature Reviews Clinical Oncology 8, 333-342 (2011)
Metastasis-suppressor genes (MSGs) are involved in diverse molecular processes in multiple tumor types; therefore, treatment strategies based on MSGs have unparalleled potential to improve patient care. In this Review, barriers specific to the translation of MSG biology into clinical practice are discussed and future research directions necessary for clinical advances are delineated.
The biology of brain metastases—translation to new therapies
April F. Eichler, Euiheon Chung, David P. Kodack, Jay S. Loeffler, Dai Fukumura & Rakesh K. Jain
doi:10.1038/nrclinonc.2011.58
Nature Reviews Clinical Oncology 8, 344-356 (2011)
Brain metastases remain a serious obstacle in the successful treatment of patients with solid tumors. This Review discusses what is known about the biology of brain metastases, what preclinical models are available to study the disease, and which novel therapeutic strategies are being studied in patients.
Bone metastasis in prostate cancer: emerging therapeutic strategies
Justin Sturge, Matthew P. Caley & Jonathan Waxman
doi:10.1038/nrclinonc.2011.67
Nature Reviews Clinical Oncology 8, 357-368 (2011)
Metastatic bone disease in advanced-stage prostate cancer causes some of the most distressing symptoms and is associated with poor survival. This Review discusses the complex pathology of the bone lesion in metastatic prostate cancer and promising therapeutic strategies to treat this disease.
Clinical implications of cancer self-seeding
Elizabeth Comen, Larry Norton & Joan Massagué
doi:10.1038/nrclinonc.2011.64
Nature Reviews Clinical Oncology 8, 369-377 (2011)
The self-seeding model provides a new paradigm whereby progression from a primary tumor to metastasis is understood as a multidirectional process, balanced between mitotic (primary tumor), seeding (metastasis) and self-seeding processes. The authors discuss how this model helps to explain various enigmas including the similarities between pre-neoplasia and invasive cancer, mammographic breast density as a risk factor, and the relationship between local control and distant recurrence.
The role of local therapy in the management of lung and liver oligometastases
Simon S. Lo, Susan D. Moffatt-Bruce, Laura A. Dawson, Roderich E. Schwarz, Bin S. Teh, Nina A. Mayr, Jiade J. Lu, John C. Grecula, Thomas E. Olencki & Robert D. Timmerman
doi:10.1038/nrclinonc.2011.75
Nature Reviews Clinical Oncology 8, 405-416 (2011)
The existence of a state of limited metastasis or oligometastasis observed in selected patients is associated with favorable outcomes. This Review discusses the role of local therapy for oligometastases that arise in lung and liver, the challenge of identifying the patients who will benefit from the treatment of their oligometastatic disease and how to select the right local therapy for these patients.
Antiangiogenic therapy, hypoxia, and metastasis: risky liaisons, or not?
Katrien De Bock, Massimiliano Mazzone & Peter Carmeliet
doi:10.1038/nrclinonc.2011.83
Nature Reviews Clinical Oncology 8, 393-404 (2011)
Anti-angiogenic therapy is thought to starve tumors by cutting their nutrient and oxygen supply. The authors review evidence for a potential link between hypoxia signaling and an invasive switch that occurs in cancer cells, through which antiangiogenic drugs could increase the risk of tumor metastasis in certain conditions, and discuss approaches to reduce tumor dissemination.
PERSPECTIVES
Oligometastases revisited
Ralph R. Weichselbaum & Samuel Hellman
doi:10.1038/nrclinonc.2011.44
Nature Reviews Clinical Oncology 8, 378-382 (2011)
This Perspectives article expands on the previously proposed clinical state of metastasis termed 'oligometastases' that refers to restricted tumor metastatic capacity. The authors outline the concept, discuss the evidence and the treatment implications and go on to describe ongoing studies in the field.
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