An international research team, including a Taiwanese researcher from National Taiwan University (NTU), has made a breakthrough in developing a way to predict the likelihood of cancer patients developing metastasis — the spread of cancer to other parts of the body — and where the specific organ of metastasis might be.
The team, consisting of researchers from 12 facilities in seven nations, proved that before cancer cells spread and grow in other organs, they release organ-seeking extracellular vesicles that travel through the bloodstream and arrive at the organs, forming a “pre-metastasis niche,” where they can locate and multiply.
Shen Tang-long (沈湯龍), an associate professor of NTU’s Department of Plant Pathology and Microbiology, who participated in the research at Cornell University for a year, presented the team’s findings on Wednesday.
Citing some concepts from the “seed and soil” theory by Stephen Paget in 1889, Shen said the study showed that the spread of cancer cells is not a matter of chance, but that the cancer cells release “fertilizers” — cell-derived vesicles, or exosomes — that arrive at particular destinations (organs) and transfer the “soil” to a suitable place for growing “seeds” (cancer cells).
Shen said the tumor-derived exosomes carry integrins — proteins that act as essential links between the extracellular environment and the intracellular signaling pathways — which function as a “zip code,” giving directions to exosomes on where to transfer to, telling them to transfer from the original tumor location to a new location for future metastasis, for example, from the breast to the liver or lungs.
If the study’s finding can be put to clinical use, precise diagnoses of metastasis could be predicted by simply performing a blood test on cancer patients and analyzing the integrins expression on exosomes collected from the blood, Shen said.
In a video conference call with other team members at Cornell, Ayuko Hoshino, a postdoctoral fellow at Cornell’s Weill Medical College, said: “The study clearly shows that cancer metastasis is started by exosomes long before tumor cells arrive at organs.”
David Lyden, an associate professor of cell and developmental biology at the college, said that, so far, in clinical data, there are no tests that help predict whether cancer patients would suffer from metastasis.
“This is the first-ever test available to predict the likelihood of cancer metastasis, and tells us what organs they will metastasize to, so this is monumental for changing our way of treating patients. If we identify that a patient is likely to go on to metastasis, then a physician needs to initiate more aggressive therapies,” Lyden said.
Wang Chiun-sheng (王俊升), a physician at NTU Hospital’s Department of Surgery and director of its Breast Center, who was not involved in the study, said oftentimes metastasis marks the failure of cancer treatment, especially if cancer cells spread to the brain, but if the destination of cancer spreading can be predicted at an earlier stage, then effective, aggressive treatment can be performed.
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