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Mego M , Mani SA , Cristofanilli M
Molecular mechanisms of metastasis in breast cancer-clinical applications
Nature Reviews Clinical Oncology. 2010 Dec;7(12) :693-701
PMID: ISI:000284756200007   
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The metastatic cascade is a series of biological processes that enable the movement of tumor cells from the primary site to a distant location and the establishment of a new cancer growth. Circulating tumor cells (CTCs) have a crucial role in tumor dissemination. The role of CTCs in treatment failure and disease progression can be explained by their relation to biological processes, including the epithelial-to-mesenchymal transition and 'self seeding', defined as reinfiltration of the primary tumor or established metastasis by more aggressive CTCs. CTCs are a unique and heterogeneous cell population with established prognostic and predictive value in certain clinical situations. The possibility of collecting sequential blood samples for real-time monitoring of systemic-therapy efficacy presents new possibilities to evaluate targeted therapies based on the genomic profiling of CTCs and to improve the clinical management of patients by personalized therapy. Interruption of the metastatic cascade via the targeting of CTCs might be a promising therapeutic strategy.
Mego, Michal Mani, Sendurai A. Cristofanilli, Massimo State of Texas Rare and Aggressive Breast Cancer Research Program ; International Union Against Cancer, American Cancer Society [ACS/08/006]; National Cancer Institute We acknowledge J. M. Reuben for discussions and critical input and K. Evans for critical reading of this Review. We apologize to the many researchers whose work we were unable to cite owing to space restrictions. M. Cristofanilli is the recipient of a grant from the State of Texas Rare and Aggressive Breast Cancer Research Program. M. Mego was supported by International Union Against Cancer, American Cancer Society International Fellowship for Beginning Investigators (ACSBI Award ACS/08/006). M. Cristofanilli and S. A. Mani are the recipients of a R01 grant from National Cancer Institute entitled Human breast cancer stem cell surrogates. 101 Nature publishing group; 75 varick st, 9th flr, new york, ny 10013-1917 usa 687dp