Preface

Excerpt

Metastasis is the major cause of death in cancer patients. As in tumorigenesis, both metastasis promoters and metastasis suppressors regulate metastasis. Metastasis suppressor genes—unlike tumor suppressor genes—inhibit metastasis without globally affecting growth of the primary tumor. Genetic alterations in these genes are rarely found in tumors, so current thinking is that they are probably regulated by epigenetic mechanisms. Thus far, around 30 metastasis suppressor genes have been identified in humans. These genes likely act by inhibiting one or more steps in the ‘metastasis cascade’, including cell migration, cell invasion, and colonization at the secondary site; they regulate a wide range of biochemical signaling pathways, and many operate in a context-dependent fashion. Most are active in several biochemical pathways, suggesting that there may be an advantage to having multiple points of control in a tumorigenic cell population. Clinical applications of metastasis suppressor genes are only at an early stage. They have been proposed as prognostic markers that can predict a better or worse outcome based on cancer recurrence. With the discovery of their detailed mechanisms of action, however, we can anticipate that translational approaches to enhance their activity and clinical trials designed specifically to target metastasis will have direct therapeutic significance. …