Cellular interactions in metastasis.

The metastatic cascade is a sequence of events that must be completed for metastases to be established. The realization that tumors are heterogeneous, consisting of many different subpopulations differing in many characteristics, and the belief that there are selective events in the metastatic process have led several laboratories to isolate and characterize variants with both high and low metastatic potential. Typically, the highly metastatic variants have been able to form distant metastases when implanted into the subcutis. Such lines have been popular for studies of metastatic mechanisms and anti-metastatic therapy, but they may be atypical examples, and thus not the best experimental models. Recent studies indicate that normal tissue influences metastasis such that many tumors metastasize only if placed in the orthotopic site. Furthermore, some cells that do not metastasize individually are able to do so in conjunction with other variant subpopulations. Thus, mixtures of tumor cells in the tissue of origin can express a more malignant character. We review possible mechanisms for such influential interactions, as well as the role of cellular interactions in generating heterogeneity and stabilizing tumor characteristics.