Laboratory of Cancer Progression Biology, Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Kooperativny Str. 5, 634009, Tomsk, Russia.
Laboratory of Epidemiology, Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Kooperativny Str. 5, 634009, Tomsk, Russia.
Clin Exp Metastasis. 2022 Aug;39(4):505-519. doi: 10.1007/s10585-022-10162-x. Epub 2022 Mar 26.
The spread of tumor cells from the primary focus, metastasis, is the main cause of cancer mortality. Therefore, anticancer therapy should be focused on the prevention of metastatic disease. Key targets can be conditions in the primary tumor that are favorable for the appearance of metastatic cells and the first steps of the metastatic cascade. Here, we discuss different approaches for targeting metastasis causes (hypoxia, metabolism changes, and tumor microenvironment) and roots (angiogenesis, epithelial-mesenchymal transition, migration, and invasion). Also, we emphasize the challenges of the existing approaches for metastasis prevention and suggest opportunities to overcome them. In conclusion, we highlight the importance of clinical evaluation of the agents showing antimetastatic effects in vivo, especially in patients with early-stage cancers, the identification of metastatic seeds, and the development of therapeutics for their eradication.
肿瘤细胞从原发性肿瘤扩散（转移）是癌症死亡的主要原因。因此，抗癌治疗应侧重于预防转移性疾病。关键靶点可以是原发性肿瘤中有利于转移性细胞出现和转移级联第一步的条件。在这里，我们讨论了针对转移原因（缺氧、代谢变化和肿瘤微环境）和根源（血管生成、上皮-间充质转化、迁移和侵袭）的不同方法。此外，我们强调了预防转移现有方法的挑战，并提出了克服这些挑战的机会。总之，我们强调了在体内显示出抗转移作用的药物进行临床评估的重要性，特别是在早期癌症患者中，确定转移性种子，并开发针对它们的治疗方法。
